Provider Demographics
NPI:1043057532
Name:KASPER, K'LEE LYNAE (BSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:K'LEE
Middle Name:LYNAE
Last Name:KASPER
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1834 BROADVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-3962
Mailing Address - Country:US
Mailing Address - Phone:208-305-1732
Mailing Address - Fax:
Practice Address - Street 1:1834 BROADVIEW DR
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-3962
Practice Address - Country:US
Practice Address - Phone:208-305-1732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID49346163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant