MEDICARE: KYLEE PROVOST DNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APN.1001449-NP	CO

General Provider Information

NPI Number	:	1104789163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLEE PROVOST DNP

Provider Business Mailing Address
First Line	:	1600 N GRAND AVE
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81003-2700
Country	:	US
Telephone Number	:	719-546-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 N GRAND AVE
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81003-2700
Country	:	US
Telephone Number	:	719-546-2500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2025
Last Update Date	:	12/06/2025

Similar Medicare Providers

1831353705 — MARCEL JABOUR JUNQUEIRA M.D.
Practice Location Address:

1600 N GRAND AVE , SUITE 140
PUEBLO, CO
81003-2700

Practice Phone: 719-564-1542
Practice Fax: 719-566-0916

1386638799 — CRAIG S. SHAPIRO M.D.
Practice Location Address:

1600 N GRAND AVE , SUITE 140
PUEBLO, CO
81003-2700

Practice Phone: 719-564-1542
Practice Fax: 719-566-0916

1457354763 — MR. HISMAN H PERCIVAL MD
Practice Location Address:

1600 N GRAND AVE , SUITE 430
PUEBLO, CO
81003-2700

Practice Phone: 719-545-8240
Practice Fax: 719-545-4319

1376539643 — DR. JAMES N MEEUWSEN MD
Practice Location Address:

1600 N GRAND AVE
PUEBLO, CO
81003-2700

Practice Phone: 719-543-6755
Practice Fax: 719-583-2236

1609866813 — LAURIE A STEIN CRNA
Practice Location Address:

1600 N GRAND AVE , SUITE 440
PUEBLO, CO
81003-2700

Practice Phone: 719-543-3500
Practice Fax: 719-543-3504

1669433751 — CARL W ADAMS MD
Practice Location Address:

1600 N GRAND AVE , SUITE 500
PUEBLO, CO
81003-2700

Practice Phone: 719-545-0663
Practice Fax:

Directions to “ KYLEE PROVOST DNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.