Provider Demographics
NPI:1508227935
Name:PROCTOR, KAYLEE (CD)
Entity type:Individual
Prefix:MRS
First Name:KAYLEE
Middle Name:
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8698 WILLIAM DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-8631
Mailing Address - Country:US
Mailing Address - Phone:785-213-8782
Mailing Address - Fax:
Practice Address - Street 1:8698 WILLIAM DR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-8631
Practice Address - Country:US
Practice Address - Phone:785-213-8782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-12
Last Update Date:2016-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174H00000XOther Service ProvidersHealth Educator