Provider Demographics
NPI:1063836971
Name:PFEIFER, KAYLA SUE (BS)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:SUE
Last Name:PFEIFER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4068
Mailing Address - Country:US
Mailing Address - Phone:402-370-4204
Mailing Address - Fax:402-370-4206
Practice Address - Street 1:123 N 4TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4068
Practice Address - Country:US
Practice Address - Phone:402-370-4204
Practice Address - Fax:402-370-4206
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator