Provider Demographics
NPI:1013803121
Name:BGOYA, KAITESI GILBERT (CNA)
Entity type:Individual
Prefix:
First Name:KAITESI
Middle Name:GILBERT
Last Name:BGOYA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LARNED
Mailing Address - State:KS
Mailing Address - Zip Code:67550-3053
Mailing Address - Country:US
Mailing Address - Phone:316-768-0299
Mailing Address - Fax:
Practice Address - Street 1:LARNED STATE HOSPITAL
Practice Address - Street 2:1301 KS-264
Practice Address - City:LARNED
Practice Address - State:KS
Practice Address - Zip Code:67550
Practice Address - Country:US
Practice Address - Phone:620-285-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS263784376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide