Provider Demographics
NPI:1235997040
Name:LA FEVER, KATHLEEN DAWN (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:DAWN
Last Name:LA FEVER
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 1:2725 HWY 51 SOUTH
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632
Mailing Address - Country:US
Mailing Address - Phone:662-429-1971
Mailing Address - Fax:662-429-1974
Practice Address - Street 1:REGION IV MENTAL HEALTH SERVICES
Practice Address - Street 2:2725 HWY 51 SO
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632
Practice Address - Country:US
Practice Address - Phone:662-429-1971
Practice Address - Fax:662-429-1974
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS887345163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse