Individual provider Active NPI

Kayla Elaine3 Garza

  • Licensed Practical Nurse
  • Appleton, WI
National Provider Identifier
1740769769
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
319551 Issued in WI
Practice address
1201 S Lee St
Appleton, WI 54915-3723
Phone
(920) 858-3302
NPI assigned
Aug 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 319551 WI Primary

Addresses

Primary practice location

1201 S Lee St
Appleton, WI 54915-3723

Mailing address

652 W 5TH Ave
Oshkosh, WI 54902-5833
Phone (920) 376-4458

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

State licenses

LicenseStateTypeSpecialty
319551WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1740769769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 W 5TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549025833",
            "telephone_number": "920-376-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S LEE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549153723",
            "telephone_number": "920-858-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZA",
        "first_name": "KAYLA",
        "middle_name": "ELAINE3",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "319551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.