MEDICARE: KYLER MEERS MSW LICSW, INC.

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
1	253Z00000X	In Home Supportive Care Agency	420	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	031204002	OTHER	MN	PRIMEWEST
2	109952	OTHER	MN	UCARE
3	990991016222	OTHER	MN	PREFERRED ONE
4	HP26196	OTHER	MN	HEAALTHPARTNERS
5	6282442	OTHER	MN	MEDICA
6	8G757ME	OTHER	MN	BLUE CROSS BLUE SHIELD OF MINNESOTA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	XZG800714487	OTHER	MN	BLUE PLUS

General Provider Information

NPI Number	:	1811140502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KYLER MEERS MSW LICSW, INC.

Provider Business Mailing Address
First Line	:	29038 KEPLER CIR
Second Line	:
City	:	COLD SPRING
State	:	MN
Zip	:	56320-9620
Country	:	US
Telephone Number	:	320-685-7158
Fax Number	:	320-685-4510

Provider Business Practice Location Address
First Line	:	29038 KEPLER CIR
Second Line	:
City	:	COLD SPRING
State	:	MN
Zip	:	56320-9620
Country	:	US
Telephone Number	:	320-685-7158
Fax Number	:	320-685-4510

Authorized Official
Title or Position	:	SOCIAL WORKER/THERAPIST
Name	:	MR. KYLER EVERETT MEERS
Credential	:	MSW LICSW
Telephone Number	:	320-685-7158

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	04/27/2009

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