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General NPI Number Information
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NPI Number | 1215639968
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Entity Type | Individual
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Provider Name | KYLEE DESIREE GEYER RNFA
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Gender | Female
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 260 N MILLWARD ST
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City | JACKSON
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State | WY
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Zip | 83001-8581
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Country | US
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Telephone | 901-569-5690
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12774
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City | JACKSON
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State | WY
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Zip | 83002-2774
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Country | US
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Telephone | 307-733-2443
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Fax | 307-733-6912
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 166039
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License Number State | ID
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