Provider Demographics
NPI:1922746593
Name:MUEGGENBURG, KYLEE
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:MUEGGENBURG
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 1:972 MISSION ST FL 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2992
Mailing Address - Country:US
Mailing Address - Phone:415-487-3300
Mailing Address - Fax:
Practice Address - Street 1:972 MISSION ST FL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2992
Practice Address - Country:US
Practice Address - Phone:415-770-5389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program