Provider Demographics
NPI:1871116608
Name:STEIMER, KYLIE ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:ROSE
Last Name:STEIMER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 COLE AVE APT 215
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-4544
Mailing Address - Country:US
Mailing Address - Phone:319-389-4963
Mailing Address - Fax:
Practice Address - Street 1:1141 KELLER PKWY STE B
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-1628
Practice Address - Country:US
Practice Address - Phone:817-200-4125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical