Provider Demographics
NPI:1578054250
Name:JAMES, KATHY JEAN
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:JEAN
Last Name:JAMES
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 1:2000 S SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2727
Mailing Address - Country:US
Mailing Address - Phone:605-271-2467
Mailing Address - Fax:605-275-6541
Practice Address - Street 1:2000 S SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2727
Practice Address - Country:US
Practice Address - Phone:605-271-2467
Practice Address - Fax:605-275-6541
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR041743163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health