Kite Group LLC

NPI #1689259269 in Scott, Louisiana

Provider Information

NPI Number: 1689259269
Entity Type: Organization
Organization Name: Kite Group LLC
Primary Specialty: Nurse Practitioner - Psychiatric/Mental Health
Enumeration Date: Mar 15, 2021
Last Updated: Mar 15, 2021

Practice Location

Address: 913 ALFRED ST
City: Scott
State: Louisiana
ZIP Code: 70583-5117
Phone: (337) 504-3697

Authorized Official

Name: AYLIE GRAY, CREDENTIALING
Title: MANAGER
Phone: (337) 581-5112

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health	363LP0808X	Primary

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