Most Relevant Information
Provider Data
| NPI Number: | 1003633975 |
| Provider Name: | KAYLA KIBODEAUX |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/23/2024 |
| Last Updated: | 09/23/2024 |
Provider Practice Location
5455 ALMIRA DR NE
BREMERTON
WA
983118331
Practice Location Phone/Fax
| Phone: | 3603735031 |
| Fax: |
Provider Mailing Location
5455 ALMIRA DR NE
BREMERTON
WA
983118331
Provider Mailing Phone/Fax
| Phone: | 3603735031 |
| Fax: |