Healthcare Provider Details

I. General information

NPI: 1720900475
Provider Name (Legal Business Name): KATIE KARLESKINT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S ASH ST
NEVADA MO
64772-3224
US

IV. Provider business mailing address

1260 190TH ST
FORT SCOTT KS
66701-7714
US

V. Phone/Fax

Practice location:
  • Phone: 417-667-3355
  • Fax:
Mailing address:
  • Phone: 573-864-7224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14-137720-061
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: