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General NPI Number Information
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NPI Number | 1740883495
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Entity Type | Individual
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Provider Name | KAYLEIGH NISSLE
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Gender | Female
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 520 E CHERRY ST
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City | TROY
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State | MO
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Zip | 63379-1410
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Country | US
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Telephone | 314-834-1400
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Fax | 314-834-1430
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Provider Business Mailing Address
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Address Line | 520 E CHERRY ST
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City | TROY
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State | MO
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Zip | 63379-1410
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Country | US
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Telephone | 314-834-1400
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Fax | 314-834-1430
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 250088
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2022022412
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License Number State | MO
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