Provider Demographics
NPI:1437711645
Name:UNGERER, KAYTLYN ALESE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KAYTLYN
Middle Name:ALESE
Last Name:UNGERER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8640 STAIR RD
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44287-9094
Mailing Address - Country:US
Mailing Address - Phone:440-371-5615
Mailing Address - Fax:
Practice Address - Street 1:2000 CENTER ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4325
Practice Address - Country:US
Practice Address - Phone:731-394-1145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty