Healthcare Provider Details

I. General information

NPI: 1164345302
Provider Name (Legal Business Name): HEATHER KAEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 IDAHO ST
WATERLOO IA
50707-2235
US

IV. Provider business mailing address

2301 IDAHO ST
WATERLOO IA
50707-2235
US

V. Phone/Fax

Practice location:
  • Phone: 319-493-7610
  • Fax:
Mailing address:
  • Phone: 319-493-7610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: