MEDICARE: KAYLA BLOMSTEDT

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	115888	NE

General Provider Information

NPI Number	:	1699572099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA BLOMSTEDT

Provider Business Mailing Address
First Line	:	2815 S LOCUST ST
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68801-8861
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 N WEBB RD STE A
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68803-3504
Country	:	US
Telephone Number	:	308-390-2663
Fax Number	:	308-365-1315

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

Provider Enumeration Date	:	02/25/2025
Last Update Date	:	06/04/2026

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Directions to “ KAYLA BLOMSTEDT ” Practice Location

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