Provider Demographics
NPI:1376208900
Name:LENZ, KAYLEE (ARNP)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:LENZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 5TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2904
Mailing Address - Country:US
Mailing Address - Phone:319-582-4614
Mailing Address - Fax:319-344-4486
Practice Address - Street 1:1101 5TH ST STE 103
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2904
Practice Address - Country:US
Practice Address - Phone:319-582-4614
Practice Address - Fax:319-344-4486
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG166326363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health