Provider Demographics
NPI:1487215935
Name:BENNETT, KAYLEE JOANNE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KAYLEE
Middle Name:JOANNE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-3642
Mailing Address - Country:US
Mailing Address - Phone:409-554-6360
Mailing Address - Fax:
Practice Address - Street 1:1295 PEARL ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-3642
Practice Address - Country:US
Practice Address - Phone:409-554-6360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX840524163W00000X
TXAP141980363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse