Healthcare Provider Details

I. General information

NPI: 1336071299
Provider Name (Legal Business Name): ELLIE LANAE CAYLOR M.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 13TH ST NW
CEDAR RAPIDS IA
52405-2404
US

IV. Provider business mailing address

220 LEE ST # 220
IOWA CITY IA
52246-3810
US

V. Phone/Fax

Practice location:
  • Phone: 515-331-3190
  • Fax:
Mailing address:
  • Phone: 515-302-4522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number138414
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: