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NPI Code Detail

MEDICARE: KILEY PRUSSO CATES RN

MEDICARE: KILEY PRUSSO CATES RN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1518812056
Entity Type Code : Individual
Provider Name (Legal Business Name) : KILEY PRUSSO CATES RN
Provider Business Mailing Address
First Line : 5992 COUNTY ROAD T
Second Line :
City : SPRING GREEN
State : WI
Zip : 53588-9008
Country : US
Telephone Number : 608-588-4366
Fax Number :
Provider Business Practice Location Address
First Line : 800 COMPASSION WAY
Second Line :
City : DODGEVILLE
State : WI
Zip : 53533-1956
Country : US
Telephone Number : 608-930-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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