Provider Demographics
NPI:1609754878
Name:JORGENSEN, KYLEE
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:JORGENSEN
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 1:702 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NE
Mailing Address - Zip Code:68769-4204
Mailing Address - Country:US
Mailing Address - Phone:605-760-9764
Mailing Address - Fax:
Practice Address - Street 1:702 W PARK AVE
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NE
Practice Address - Zip Code:68769-4204
Practice Address - Country:US
Practice Address - Phone:605-760-9764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider