Kyra Roof, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN298202 Issued in PA

Practice address

15 S 9TH St
Lebanon, PA 17042-5104

Phone

(717) 273-5992

Fax

(717) 273-5995

NPI assigned

Jan 22, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kyra Nixon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1336657592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N PRINCE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033010",
            "telephone_number": "717-560-7917",
            "fax_number": "717-560-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S 9TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425104",
            "telephone_number": "717-273-5992",
            "fax_number": "717-273-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOF",
        "first_name": "KYRA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-22",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN298202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYRA",
            "last_name": "NIXON",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ben Z Roitberg, MD
• Michael Rojek
• Jill Kay Roling, LCSW
• Lesley Anne Rollins, MPH, RDN, CHES
• Daniel P Rollo, M.D.
• Melanie Root, MD
• Roots Recovery LLC
• Michele Rosario Melendez, PHARM D, RPH
• Gina Brooke Roscoe
• Brittany Rose

• Licensed Practical Nurse in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Licensed Practical Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.