Provider Demographics
NPI:1639741929
Name:GEHRING, KAYTLYN RAYNE
Entity Type:Individual
Prefix:
First Name:KAYTLYN
Middle Name:RAYNE
Last Name:GEHRING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 N. BUHLER RD.
Mailing Address - Street 2:
Mailing Address - City:BUHLER
Mailing Address - State:KS
Mailing Address - Zip Code:67522
Mailing Address - Country:US
Mailing Address - Phone:620-899-5569
Mailing Address - Fax:
Practice Address - Street 1:10215 N. BUHLER RD.
Practice Address - Street 2:
Practice Address - City:BUHLER
Practice Address - State:KS
Practice Address - Zip Code:67522
Practice Address - Country:US
Practice Address - Phone:620-899-5569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2400133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered