Healthcare Provider Details

I. General information

NPI: 1861230872
Provider Name (Legal Business Name): KAYLEIGH VICTORIA PRIEBE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2024
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 3RD ST SW
CANTON OH
44702-1607
US

IV. Provider business mailing address

236 3RD ST SW
CANTON OH
44702-1607
US

V. Phone/Fax

Practice location:
  • Phone: 330-754-4431
  • Fax: 330-244-8839
Mailing address:
  • Phone: 236-344-7023
  • Fax: 330-244-8839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0037076
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN.378184
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: