Healthcare Provider Details
I. General information
NPI: 1043970668
Provider Name (Legal Business Name): TAYLOR KATHLEEN LOFINK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/22/2021
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1104 W 8TH ST
YANKTON SD
57078-3306
US
IV. Provider business mailing address
1104 W 8TH ST
YANKTON SD
57078-3306
US
V. Phone/Fax
- Phone: 605-665-7841
- Fax:
- Phone: 605-665-7841
- Fax: 605-665-8337
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: