Healthcare Provider Details

I. General information

NPI: 1932010899
Provider Name (Legal Business Name): KYLEE HENRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5881 US HIGHWAY 22 W
CIRCLEVILLE OH
43113-9657
US

IV. Provider business mailing address

5881 US HIGHWAY 22 W
CIRCLEVILLE OH
43113-9657
US

V. Phone/Fax

Practice location:
  • Phone: 740-207-9331
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: