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NPI Code Detail

MEDICARE: PATRICIA KANN MA, CCC-SLP

MEDICARE: PATRICIA KANN MA, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1467846998
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA KANN MA, CCC-SLP
Provider Business Mailing Address
First Line : 16 RED BRIDGE DR
Second Line :
City : SIOUX CITY
State : IA
Zip : 51104-1061
Country : US
Telephone Number : 712-574-1829
Fax Number :
Provider Business Practice Location Address
First Line : 3625 G ST
Second Line :
City : SOUTH SIOUX CITY
State : NE
Zip : 68776-3466
Country : US
Telephone Number : 402-494-3061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2015
Last Update Date : 03/23/2015

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Directions to “ PATRICIA KANN MA, CCC-SLP” Practice Location

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