Provider Demographics
NPI:1821752478
Name:CLAYBROOK, KYLEIGH (LPN)
Entity Type:Individual
Prefix:
First Name:KYLEIGH
Middle Name:
Last Name:CLAYBROOK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 ALBIA RD
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-3907
Mailing Address - Country:US
Mailing Address - Phone:641-682-8772
Mailing Address - Fax:641-682-1924
Practice Address - Street 1:1527 ALBIA RD
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-3907
Practice Address - Country:US
Practice Address - Phone:641-682-8772
Practice Address - Fax:641-682-1924
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP60729164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse