Individual provider · Type 1 NPI

Kylee Provost, DNP

Nurse Practitioner · Pueblo, CO

NPI number 1104789163 Active

Practice location

1600 N Grand Ave
Pueblo, CO 81003-2700

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XAPN.1001449-NP (CO)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1104789163

Kylee Provost, DNP's National Provider Identifier is 1104789163, issued on Dec 6, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Pueblo, CO. The record was last updated on Dec 6, 2025.