Provider Demographics
NPI:1467543124
Name:KYHL, LARA LEA (ARNP)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:LEA
Last Name:KYHL
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 1:31379 302ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:IA
Mailing Address - Zip Code:50660-8602
Mailing Address - Country:US
Mailing Address - Phone:319-240-8116
Mailing Address - Fax:
Practice Address - Street 1:1001 MASON WAY
Practice Address - Street 2:
Practice Address - City:SHELL ROCK
Practice Address - State:IA
Practice Address - Zip Code:50670-1007
Practice Address - Country:US
Practice Address - Phone:319-885-6530
Practice Address - Fax:877-325-1948
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA095740363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1467543124Medicaid
IA716260101Medicare PIN