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NPI Code Detail

MEDICARE: MS. KATHLEEN R INGLE FNP

MEDICARE:  MS. KATHLEEN R INGLE  FNP
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
1363L00000XNurse PractitionerCP001708SD
2363LF0000XFamily Nurse PractitionerR-194623-1MN
3363LF0000XFamily Nurse PractitionerAP127468TX
4363LF0000XFamily Nurse PractitionerCP001708SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811949266
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN R INGLE FNP
Provider Business Mailing Address
First Line : PO BOX 6020
Second Line :
City : RAPID CITY
State : SD
Zip : 57709-6020
Country : US
Telephone Number : 605-342-3280
Fax Number : 605-721-8458
Provider Business Practice Location Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5474
Country : US
Telephone Number : 605-342-3280
Fax Number : 605-721-8458
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 12/17/2024

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