Provider Demographics
NPI:1235127424
Name:DIEBALL, KAYLA ROSE (APRN)
Entity Type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:ROSE
Last Name:DIEBALL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 CHARLES PL
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2750
Mailing Address - Country:US
Mailing Address - Phone:785-537-4200
Mailing Address - Fax:785-537-4354
Practice Address - Street 1:1600 CHARLES PL
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2750
Practice Address - Country:US
Practice Address - Phone:785-537-4200
Practice Address - Fax:785-537-4354
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45777363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1615588OtherBCBS OF KS
P00281161OtherRAILROAD MEDICARE
KS200347920AMedicaid
1615588Medicare PIN