Provider Demographics
NPI:1881492726
Name:AUFDENGARTEN, KYLE MARK
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:MARK
Last Name:AUFDENGARTEN
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:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:BRULE
Mailing Address - State:NE
Mailing Address - Zip Code:69127-0094
Mailing Address - Country:US
Mailing Address - Phone:308-280-0681
Mailing Address - Fax:
Practice Address - Street 1:516 MAPLE ST
Practice Address - Street 2:
Practice Address - City:BRULE
Practice Address - State:NE
Practice Address - Zip Code:69127-3562
Practice Address - Country:US
Practice Address - Phone:308-280-0682
Practice Address - Fax:308-280-0682
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion