Provider Demographics
NPI:1730886573
Name:HANSEN - MORE, KYLEIGH
Entity type:Individual
Prefix:
First Name:KYLEIGH
Middle Name:
Last Name:HANSEN - MORE
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 1:2573 BEAVER RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:MOGADORE
Mailing Address - State:OH
Mailing Address - Zip Code:44260-1833
Mailing Address - Country:US
Mailing Address - Phone:330-531-5819
Mailing Address - Fax:
Practice Address - Street 1:12415 GREENBOWER RD
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601
Practice Address - Country:US
Practice Address - Phone:330-807-4644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide