Provider Demographics
NPI:1861664583
Name:KINDIG, DEBORHA E (LPN)
Entity Type:Individual
Prefix:
First Name:DEBORHA
Middle Name:E
Last Name:KINDIG
Suffix:
Gender:F
Credentials:LPN
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 5410
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51102
Mailing Address - Country:US
Mailing Address - Phone:712-252-2477
Mailing Address - Fax:712-252-5516
Practice Address - Street 1:1021 NEBRASKA ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51105
Practice Address - Country:US
Practice Address - Phone:712-252-2477
Practice Address - Fax:712-252-5516
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP21033164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse