Provider Demographics
NPI:1417152224
Name:OSTMEYER, KATHLEEN ANN
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:OSTMEYER
Suffix:
Gender:F
Credentials:
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 97
Mailing Address - Street 2:602 S. JEFFERSON
Mailing Address - City:GRINNELL
Mailing Address - State:KS
Mailing Address - Zip Code:67738-0097
Mailing Address - Country:US
Mailing Address - Phone:785-824-3773
Mailing Address - Fax:
Practice Address - Street 1:602 S. JEFFERSON
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:KS
Practice Address - Zip Code:67738-0097
Practice Address - Country:US
Practice Address - Phone:785-824-3773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant