MEDICARE: KAYLEE ANDERSON APRN

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	363LF0000X	Family Nurse Practitioner	1026788	TX

General Provider Information

NPI Number	:	1942162508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE ANDERSON APRN

Provider Business Mailing Address
First Line	:	510 N VALLEY MILLS DR STE 505
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-6078
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 N VALLEY MILLS DR STE 505
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-6078
Country	:	US
Telephone Number	:	254-269-4387
Fax Number	:

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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Directions to “ KAYLEE ANDERSON APRN” Practice Location

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