Provider Demographics
NPI:1023861507
Name:HEIN, KAYLEA RENEE
Entity type:Individual
Prefix:
First Name:KAYLEA
Middle Name:RENEE
Last Name:HEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6122 W YORK CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67215-1803
Mailing Address - Country:US
Mailing Address - Phone:316-554-4757
Mailing Address - Fax:
Practice Address - Street 1:125 W COOPER ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:KS
Practice Address - Zip Code:67579-1533
Practice Address - Country:US
Practice Address - Phone:316-554-4757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer