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NPI Code Detail

MEDICARE: KYLEE MCKENZIE SMITH PA

MEDICARE: KYLEE MCKENZIE SMITH PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1477277887
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLEE MCKENZIE SMITH PA
Provider Business Mailing Address
First Line : 2000 UNIVERSITY AVE
Second Line :
City : DUBUQUE
State : IA
Zip : 52001-5050
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2000 UNIVERSITY AVE
Second Line :
City : DUBUQUE
State : IA
Zip : 52001-5050
Country : US
Telephone Number : 563-589-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2022
Last Update Date : 10/01/2025

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Directions to “ KYLEE MCKENZIE SMITH PA” Practice Location

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