MEDICARE: NANETH KALLIO

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	172A00000X	Driver
2	372500000X	Chore Provider
3	372600000X	Adult Companion
4	3747P1801X	Personal Care Attendant
5	376J00000X	Homemaker
6	376K00000X	Nurse's Aide
7	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1790373280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANETH KALLIO

Provider Business Mailing Address
First Line	:	22976 MORNINGLIGHT DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57703-9039
Country	:	US
Telephone Number	:	605-431-4778
Fax Number	:

Provider Business Practice Location Address
First Line	:	22976 MORNINGLIGHT DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57703-9039
Country	:	US
Telephone Number	:	605-431-4778
Fax Number	:	605-872-6010

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

Provider Enumeration Date	:	01/09/2021
Last Update Date	:	01/09/2021

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Directions to “ NANETH KALLIO ” Practice Location

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