Provider Demographics
NPI:1558354605
Name:KAIL, ROBERT LEROY (FNP)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LEROY
Last Name:KAIL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5452 S PINEHURST AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-2768
Mailing Address - Country:US
Mailing Address - Phone:417-988-9929
Mailing Address - Fax:
Practice Address - Street 1:5452 S PINEHURST AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-2768
Practice Address - Country:US
Practice Address - Phone:417-988-9929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000164718363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily