Individual provider Active NPI

Kendra Niehaus

  • Licensed Practical Nurse
  • Garnavillo, IA
National Provider Identifier
1386555282
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
P62723 Issued in IA
Practice address
24392 Holly Ave
Garnavillo, IA 52049-8101
Phone
(563) 880-6960
NPI assigned
Sep 17, 2026
Last updated
Sep 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P62723 IA Primary

Addresses

Primary practice location

24392 Holly Ave
Garnavillo, IA 52049-8101

Mailing address

24392 Holly Ave
Garnavillo, IA 52049-8101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1789603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1386555282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24392 HOLLY AVE",
            "city": "GARNAVILLO",
            "state": "IA",
            "postal_code": "520498101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24392 HOLLY AVE",
            "city": "GARNAVILLO",
            "state": "IA",
            "postal_code": "520498101",
            "telephone_number": "563-880-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEHAUS",
        "first_name": "KENDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-17",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P62723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garnavillo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.