Provider Demographics
NPI:1598647620
Name:ONKEN, KYLE MARVIN
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:MARVIN
Last Name:ONKEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 DURKEES RUN DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-5560
Mailing Address - Country:US
Mailing Address - Phone:765-586-8987
Mailing Address - Fax:
Practice Address - Street 1:136 DURKEES RUN DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5560
Practice Address - Country:US
Practice Address - Phone:765-586-8987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program