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NPI Code Detail

MEDICARE: KAYLEE DAWN EGAN

MEDICARE: KAYLEE DAWN EGAN
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
1106S00000XBehavior Technician
2224Z00000XOccupational Therapy AssistantOT-A2191AR

General Provider Information

NPI Number : 1801557855
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEE DAWN EGAN
Provider Business Mailing Address
First Line : 1000 SWN DR STE 101
Second Line :
City : CONWAY
State : AR
Zip : 72032-2558
Country : US
Telephone Number : 501-328-3274
Fax Number :
Provider Business Practice Location Address
First Line : 2805 ALMA HWY
Second Line :
City : VAN BUREN
State : AR
Zip : 72956-5021
Country : US
Telephone Number : 479-471-9600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2022
Last Update Date : 03/18/2026

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Directions to “ KAYLEE DAWN EGAN ” Practice Location

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