Healthcare Provider Details

I. General information

NPI: 1205324506
Provider Name (Legal Business Name): JENNIFER KIRSCHENMAN CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 7TH ST
EUREKA SD
57437-2175
US

IV. Provider business mailing address

PO BOX 185
EUREKA SD
57437-0185
US

V. Phone/Fax

Practice location:
  • Phone: 605-284-2503
  • Fax: 605-284-5307
Mailing address:
  • Phone: 605-284-2503
  • Fax: 605-284-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA028863
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: