Provider Demographics
NPI:1861926115
Name:LAMB, KYLEE (LPN)
Entity type:Individual
Prefix:MRS
First Name:KYLEE
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 LILAC ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3526
Mailing Address - Country:US
Mailing Address - Phone:360-575-7019
Mailing Address - Fax:360-575-7022
Practice Address - Street 1:2715 LILAC ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3526
Practice Address - Country:US
Practice Address - Phone:360-575-7019
Practice Address - Fax:360-575-7022
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60499657164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse