Provider Demographics
NPI:1649064247
Name:EGLI, KYLEE RAE
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:RAE
Last Name:EGLI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 STEARNS LANE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-3212
Mailing Address - Country:US
Mailing Address - Phone:570-764-0286
Mailing Address - Fax:
Practice Address - Street 1:9 STEARNS LANE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-3212
Practice Address - Country:US
Practice Address - Phone:570-764-0286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN760164163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse