KAYLEE DIRCKS (NPI# 1316504467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316504467 |
| Entity Type | Individual |
| Full Name | KAYLEE DIRCKS |
| Practice Address |
12545 320 1/2 Ave Nw Princeton MN 55371-4744 |
| Mailing Address |
12208 313th Ave Princeton MN 55371-3320 |
| Practice Telephone | 6128047212 |
| Mailing Telephone | 6128047212 |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-05-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
12545 320 1/2 AVE NW |
| City | PRINCETON |
| State | MN |
| Zip Code | 55371-4744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053962530 | Monica Gail Broten | Technician | 30840 Tiger Street Nw, Princeton, MN 55371 | 2019-09-25 |
| 1215349584 | Stephen Destefano | Pharmacist | 31419 131st Street, Princeton, MN 55371 | 2014-05-21 |
| 1164798948 | Andrew Sudbeck | Counselor | 101 18th Avenue North, Princeton, MN 55371 | 2012-03-27 |
| 1073804803 | Sterling Pointe Senior Living LLC | Assisted Living Facility | 1250 Northland Drive, Princeton, MN 55371 | 2011-04-27 |
| 1568752533 | Rum River Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3079 90th Avenue, Princeton, MN 55371 | 2011-04-12 |
| 1780989038 | Dr. Kynan Westermeyer, Dds, Pllc | Clinic/Center | 404 1st St. N, Princeton, MN 55371 | 2011-01-18 |
| 1275788085 | Cody James Leff | Pharmacist | 1100 11th Avenue South, Princeton, MN 55371 | 2008-11-20 |
| 1164679213 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1101 N 5th St, Princeton, MN 55371 | 2008-08-20 |
| 1801059639 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1506 1st Street, Princeton, MN 55371 | 2008-07-02 |
| 1497940928 | James Michael Mandt | Pharmacist | 911 Northland Drive, Fairview Northland Medical Center, Princeton, MN 55371 | 2007-09-07 |
| Find all providers in zip 55371 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336691 | Emily Burris | Massage Therapist | 1202 Juniper, Princeton, TX 75407-2867 | 2020-11-03 |
| 1669087532 | Linda Nisi Raudales | Massage Therapist | 2021 Shady Glen Trl, Princeton, TX 75407-2661 | 2020-09-09 |
| 1407460769 | Tamisha Bourne | Massage Therapist | 828 Mckinley Ct, Princeton, NJ 08540-1687 | 2020-09-03 |
| 1033743257 | Terreca Antoinette Foster | Massage Therapist | 1518 Hill Top Ct, Princeton, TX 75407-0879 | 2020-02-26 |
| 1841748696 | Rory Dillon | Massage Therapist | 140 Misty Ln, Princeton, WV 24740-6462 | 2016-09-21 |
| 1417305764 | Ashley Thomas | Massage Therapist | 479 New Hope Rd, Princeton, WV 24740-8933 | 2016-05-26 |
| 1659742344 | Alice Pan | Massage Therapist | 27 Witherspoon St, Princeton, NJ 08542-3237 | 2015-10-07 |
| 1275911703 | Zhanna Root | Massage Therapist | 264 Nassau St, Princeton, NJ 08542-4622 | 2015-05-17 |
| 1528462421 | Hair Studio and Day Spa, Inc | Massage Therapist | 313 Locust St, Princeton, WV 24740-3625 | 2014-10-21 |
| 1912300245 | Peter Richard Hotz | Massage Therapist | 313 Locust St., Princeton, WV 24740 | 2014-10-01 |
| Find all providers in PRINCETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.