MEDICARE: KAIAH OPEL APRN

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	363LA2100X	Acute Care Nurse Practitioner	11028820	FL
2	363LA2100X	Acute Care Nurse Practitioner	1167890	TX

General Provider Information

NPI Number	:	1982483368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAIAH OPEL APRN

Provider Business Mailing Address
First Line	:	5224 75TH ST STE D
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79424-2525
Country	:	US
Telephone Number	:	806-712-1096
Fax Number	:	806-771-2093

Provider Business Practice Location Address
First Line	:	4681 COLLEGE PARK DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-1526
Country	:	US
Telephone Number	:	512-671-1100
Fax Number	:

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

Provider Enumeration Date	:	09/26/2023
Last Update Date	:	01/12/2026

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