MEDICARE: KAYLEE RENEE PHILLIPS DSP. PCA

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1922938703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE RENEE PHILLIPS DSP. PCA

Provider Business Mailing Address
First Line	:	431 KEEN AVE
Second Line	:
City	:	ASHLAND
State	:	OH
Zip	:	44805-3845
Country	:	US
Telephone Number	:	567-203-9609
Fax Number	:

Provider Business Practice Location Address
First Line	:	431 KEEN AVE
Second Line	:
City	:	ASHLAND
State	:	OH
Zip	:	44805-3845
Country	:	US
Telephone Number	:	567-203-9609
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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