Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 899 | ND |
NPI | 1851663983 |
---|---|
Provider Name | Dr. Kayla Rose Neibauer |
First Address | Bismarck, ND 58503-5539 |
Second Address | Bismarck, ND 58503-5539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2012 |
Last Update Date | 16/10/2015 |