Healthcare Provider Details

I. General information

NPI: 1447115894
Provider Name (Legal Business Name): KAYLA KANE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 S 4TH ST
CLINTON IA
52732-5726
US

IV. Provider business mailing address

500 W RIVER DR
DAVENPORT IA
52801-1014
US

V. Phone/Fax

Practice location:
  • Phone: 563-336-3000
  • Fax: 563-336-3044
Mailing address:
  • Phone: 563-336-3000
  • Fax: 563-336-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA188420
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: