Provider Demographics
NPI:1518787274
Name:IRONS, MCKYLIE PAIGE
Entity type:Individual
Prefix:
First Name:MCKYLIE
Middle Name:PAIGE
Last Name:IRONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 PEARL ST APT 338C
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-4126
Mailing Address - Country:US
Mailing Address - Phone:432-880-3972
Mailing Address - Fax:
Practice Address - Street 1:1333 PEARL ST APT 338C
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4126
Practice Address - Country:US
Practice Address - Phone:143-288-0397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program