Provider Demographics
NPI:1780881391
Name:GEER, KYLEE BETH
Entity type:Individual
Prefix:MRS
First Name:KYLEE
Middle Name:BETH
Last Name:GEER
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 1:315 MAIN STREET S.
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-3731
Mailing Address - Country:US
Mailing Address - Phone:701-837-9801
Mailing Address - Fax:866-666-9789
Practice Address - Street 1:315 MAIN STREET S.
Practice Address - Street 2:SUITE 104
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3731
Practice Address - Country:US
Practice Address - Phone:701-837-9801
Practice Address - Fax:866-666-9789
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND987235Z00000X
MN8191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND28240OtherBCBS
ND51627Medicaid