Provider Demographics
NPI:1518684265
Name:BERTRAND, KAYLEE JO (RN)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:JO
Last Name:BERTRAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6508 W 56TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-1959
Mailing Address - Country:US
Mailing Address - Phone:712-301-4727
Mailing Address - Fax:
Practice Address - Street 1:345 W STEAMBOAT DR STE 300
Practice Address - Street 2:
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5287
Practice Address - Country:US
Practice Address - Phone:605-217-2175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR056747163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical