Provider Demographics
NPI:1225904907
Name:GEBS, KYLE (FNP-C)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:GEBS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4290 SAINT ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-1293
Mailing Address - Country:US
Mailing Address - Phone:208-821-0105
Mailing Address - Fax:
Practice Address - Street 1:3500 POTOMAC WAY
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-4950
Practice Address - Country:US
Practice Address - Phone:208-522-7666
Practice Address - Fax:208-524-2821
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-11
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1371783207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty