Basic Information
| Provider Information | |||||||||
| NPI: | 1750805727 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUEHL | ||||||||
| FirstName: | KAYELA | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ASPLUND | ||||||||
| OtherFirstName: | KAYELA | ||||||||
| OtherMiddleName: | S | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | NP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3409 LUDINGTON ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | ESCANABA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 498294213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9067894414 | ||||||||
| FaxNumber: | 9067894406 | ||||||||
| Practice Location | |||||||||
| Address1: | 145 4TH AVE N | ||||||||
| Address2: | |||||||||
| City: | GLADSTONE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 498371054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9064283273 | ||||||||
| FaxNumber: | 9064281881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2017 | ||||||||
| LastUpdateDate: | 11/13/2018 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 4704250114 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | M05250086 | 01 | MI | MEDICARE | OTHER | 0878479 | 01 | MI | BCBS | OTHER | 1750805727 | 05 | MI | MEDICAID |