Healthcare Provider Details

I. General information

NPI: 1992410906
Provider Name (Legal Business Name): KAYCEE LYN CARROSCIA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYCEE LYN PARRILLO FNP

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 1ST ST SW
ROCHESTER MN
55905-0006
US

IV. Provider business mailing address

PO BOX 860912
MINNEAPOLIS MN
55486-0912
US

V. Phone/Fax

Practice location:
  • Phone: 507-284-2511
  • Fax:
Mailing address:
  • Phone: 507-284-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number228294
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10749
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: