Provider Demographics
NPI:1619062437
Name:KILMER, KYRA (NP)
Entity Type:Individual
Prefix:MS
First Name:KYRA
Middle Name:
Last Name:KILMER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KYRA
Other - Middle Name:
Other - Last Name:BASS/TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-0400
Mailing Address - Country:US
Mailing Address - Phone:530-527-0350
Mailing Address - Fax:530-529-3881
Practice Address - Street 1:TEHAMA COUNTY HEALTH SERVICES CLINIC DIVISON
Practice Address - Street 2:1850 WALNUT ST SUITE E
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080
Practice Address - Country:US
Practice Address - Phone:530-527-0350
Practice Address - Fax:530-529-3881
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2259875363L00000X, 363LF0000X, 363L00000X
CANP95004283363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400190812Medicare PIN
NY312014OtherWELLCARE
NY02632268Medicaid
NY000408560001OtherBLUE SHIELD OF NENY
NY780E11OtherEMPIRE BLUE CROSS
NY050429000070OtherFIDELIS
NY141655014OtherAETNA
NY0015055OtherGHI
NY86997OtherGHI HMO
NY141655014OtherEMPIRE PLAN
NY141655014OtherSHARED HEALTH NETWORK
NY141655014OtherUNITED HEALTHCARE
NY4129366OtherMVP
NYQ36253Medicare UPIN
MAS400190812Medicare PIN