Kylie Dyann Eitzmann

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

Practice address

3800 American Blvd W Ste 740
Bloomington, MN 55431-4422

Phone

(402) 879-5957

NPI assigned

Jan 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lovaas Institute for Early Intervention - Midwest, Inc.

  • Community/Behavioral Health Agency
  • Bloomington, MN
  • NPI 1487732764
  NPD

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1396450912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 AMERICAN BLVD W STE 740",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 AMERICAN BLVD W STE 740",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314422",
            "telephone_number": "402-879-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EITZMANN",
        "first_name": "KYLIE",
        "middle_name": "DYANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenace Ecklund Edwall, PH.D., PSY.D.
• Edwards Ridecare Inc.
• Linda Eelkema, MD
• Isra Eid
• Sonya S. Eikum, MS ATC ATR
• Jeffrey N Elder, MD
• Brent A. Elert, MD
• Elevate Mental Health LLC (Elevate Mental Health)
• Elevated Care Service
• Sergio Augusto Elias, DDS

• Assistant Behavior Analyst in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Assistant Behavior Analyst in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.