Provider Demographics
NPI:1104710417
Name:KREBS, KAITLYN CORRINE ELIZABETH
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:CORRINE ELIZABETH
Last Name:KREBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 STANTON AVE UNIT 19
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-7268
Mailing Address - Country:US
Mailing Address - Phone:847-246-2814
Mailing Address - Fax:
Practice Address - Street 1:1350 BEARDSHEAR HALL
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50011-2025
Practice Address - Country:US
Practice Address - Phone:515-294-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer