Provider Demographics
NPI:1346984960
Name:DIGIACINTO, KYLIE B (CRNA)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:B
Last Name:DIGIACINTO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KYLIE
Other - Middle Name:B
Other - Last Name:STOTTLEMYRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 412431
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-2431
Mailing Address - Country:US
Mailing Address - Phone:913-647-4100
Mailing Address - Fax:913-647-4120
Practice Address - Street 1:100 NE SAINT LUKES BLVD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-6000
Practice Address - Country:US
Practice Address - Phone:816-347-5097
Practice Address - Fax:816-347-5045
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017003977163W00000X
MO2022018939367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO910112022Medicaid
MO67705011OtherBCBS KC