Provider Demographics
NPI:1316517261
Name:NEMETH, KAITLYN ALYSSA (PT, DPT)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ALYSSA
Last Name:NEMETH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:ALYSSA
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:8901 BENT TREE DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-3275
Mailing Address - Country:US
Mailing Address - Phone:316-706-3754
Mailing Address - Fax:
Practice Address - Street 1:1601 N COLLINS BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3520
Practice Address - Country:US
Practice Address - Phone:972-470-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1106713225100000X
TX1347425225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist