Healthcare Provider Details

I. General information

NPI: 1750908299
Provider Name (Legal Business Name): KALEY BEBOUT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 US HIGHWAY 68 E UNIT B
BENTON KY
42025-8336
US

IV. Provider business mailing address

34 US HIGHWAY 68 E UNIT B
BENTON KY
42025-8336
US

V. Phone/Fax

Practice location:
  • Phone: 270-527-4933
  • Fax: 270-414-0030
Mailing address:
  • Phone: 270-527-4933
  • Fax: 270-414-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3014671
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: