Kassidy Kaye Wyatt, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

2301781 Issued in MN

Practice address

1215 Aldrich Way
Faribault, MN 55021-7031

Phone

(760) 960-8301

NPI assigned

Jun 14, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kassidy Kaye Hayes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1912740366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 ALDRICH WAY",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550217031",
            "telephone_number": "760-960-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 ALDRICH WAY",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550217031",
            "telephone_number": "760-960-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "KASSIDY",
        "middle_name": "KAYE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "2301781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASSIDY",
            "last_name": "HAYES",
            "middle_name": "KAYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kenya Marie Wilson
• Nathan Winterhalter
• Ray W Wood, MD
• Dulce Wroblewski
• Hollis Wunderlich, LPCC
• Diane Marie Wynn Dehnert
• Txong Xiong, L. AC
• Ericka Yang
• Saredo Yacin Youssouf
• Julie Ann Zachwieja, D.O., B.S.

• Home Health Registered Nurse in Faribault, MN
• Providers in Faribault, MN by specialty
• Home Health Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.