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General NPI Number Information
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NPI Number | 1053903047
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Entity Type | Individual
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Provider Name | KATHERINE ESTELLE KIRKIE RN
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Gender | Female
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 1323 BIA RT 4
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City | FORT THOMPSON
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State | SD
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Zip | 57339-0200
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Country | US
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Telephone | 605-245-1540
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Fax | 605-245-2384
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Provider Business Mailing Address
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Address Line | PO BOX 200
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City | FORT THOMPSON
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State | SD
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Zip | 57339-0200
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Country | US
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Telephone | 605-245-1586
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Fax | 605-245-2384
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN021966
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License Number State | SD
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