Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 12376 | KS |
NPI | 1033795661 |
---|---|
Provider Name | Kayla M Ewers |
First Address | Manhattan, KS 66502-3358 |
Second Address | Fort Riley, KS 66442 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2021 |
Last Update Date | 23/03/2021 |