Provider Demographics
NPI:1861036832
Name:TARUFELLI, KAILEY (APRN-CNP, PMHNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:KAILEY
Middle Name:
Last Name:TARUFELLI
Suffix:
Gender:F
Credentials:APRN-CNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 CORAL ST
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-6615
Mailing Address - Country:US
Mailing Address - Phone:303-501-7600
Mailing Address - Fax:
Practice Address - Street 1:2620 COMMERCIAL WAY STE 140
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-4750
Practice Address - Country:US
Practice Address - Phone:307-212-5116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-03
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY35882163W00000X
WY46161363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty