Provider Demographics
NPI:1538681846
Name:BURTON, KAYLEE M
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:M
Last Name:BURTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:M
Other - Last Name:WHITEHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2780 FREDERICA ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-5442
Mailing Address - Country:US
Mailing Address - Phone:270-926-4100
Mailing Address - Fax:270-684-4678
Practice Address - Street 1:2780 FREDERICA ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-5442
Practice Address - Country:US
Practice Address - Phone:270-926-4100
Practice Address - Fax:270-684-4678
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist