Provider Demographics
NPI:1659177780
Name:YENTER, KATHY SUE
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:SUE
Last Name:YENTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 MEARS ST
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2226
Mailing Address - Country:US
Mailing Address - Phone:970-646-5942
Mailing Address - Fax:
Practice Address - Street 1:156 MEARS ST
Practice Address - Street 2:
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-2250
Practice Address - Country:US
Practice Address - Phone:308-432-2792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion