Provider Demographics
NPI:1871321687
Name:WIENS, KAYLEE JO (PA)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:JO
Last Name:WIENS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:520 S SANTA FE AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4190
Mailing Address - Country:US
Mailing Address - Phone:785-452-6440
Mailing Address - Fax:785-452-6441
Practice Address - Street 1:520 S SANTA FE AVE STE 240
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4190
Practice Address - Country:US
Practice Address - Phone:785-452-6440
Practice Address - Fax:785-452-6441
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2025-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS15-02949363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant