Provider Demographics
NPI:1407300601
Name:MEYER, KYLEE RAE (APRN)
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:RAE
Last Name:MEYER
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 1:3307 BARADA ST
Mailing Address - Street 2:PO BOX 399
Mailing Address - City:FALLS CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68355-2470
Mailing Address - Country:US
Mailing Address - Phone:402-246-6545
Mailing Address - Fax:402-245-6640
Practice Address - Street 1:3307 BARADA ST
Practice Address - Street 2:
Practice Address - City:FALLS CITY
Practice Address - State:NE
Practice Address - Zip Code:68355-2470
Practice Address - Country:US
Practice Address - Phone:402-246-6545
Practice Address - Fax:402-245-6640
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily