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General NPI Number Information
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NPI Number | 1437545951
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Entity Type | Individual
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Provider Name | KYLEE STEVENSON DC
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Gender | Female
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Dates
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Enumeration Date | 04/10/2015
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Last Update Date | 02/09/2019
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Provider Practice Location Address
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Address Line | 19555 W BLUEMOUND RD STE 6
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City | BROOKFIELD
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State | WI
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Zip | 53045
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Country | US
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Telephone | 262-649-7876
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Fax | 262-456-5930
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Provider Business Mailing Address
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Address Line | 19555 W BLUEMOUND RD STE 6
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City | BROOKFIELD
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State | WI
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Zip | 53045-5934
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Country | US
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Telephone | 360-461-5777
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5379-12
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License Number State | WI
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