=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033081864
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAYLA M GOLAY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2025
-----------------------------------------------------
Last Update Date | 09/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 207 N CENTRAL AVE
-----------------------------------------------------
City | SUPERIOR
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68978-1736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-879-3235
-----------------------------------------------------
Fax | 402-879-3239
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 216 N DENVER AVE
-----------------------------------------------------
City | HASTINGS
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68901-5138
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-462-5107
-----------------------------------------------------
Fax | 402-462-5126
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 372600000X
-----------------------------------------------------
Taxonomy Name | Adult Companion
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------