Provider Demographics
NPI:1083024863
Name:MAGERS, KATHRYN (RN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:MAGERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:213 S. GREEN ST
Mailing Address - City:LANCASTER
Mailing Address - State:MO
Mailing Address - Zip Code:63548
Mailing Address - Country:US
Mailing Address - Phone:660-457-3721
Mailing Address - Fax:660-457-2238
Practice Address - Street 1:213 S. GREEN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:MO
Practice Address - Zip Code:63548
Practice Address - Country:US
Practice Address - Phone:660-457-3721
Practice Address - Fax:660-457-2238
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011000651163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health