Provider Demographics
NPI:1669220687
Name:JOPSON, KAYLEIGH ELIZABETH (CNP)
Entity type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:ELIZABETH
Last Name:JOPSON
Suffix:
Gender:F
Credentials:CNP
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 33
Mailing Address - Street 2:
Mailing Address - City:COLMAN
Mailing Address - State:SD
Mailing Address - Zip Code:57017-0033
Mailing Address - Country:US
Mailing Address - Phone:605-864-8587
Mailing Address - Fax:
Practice Address - Street 1:400 22ND AVE
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2447
Practice Address - Country:US
Practice Address - Phone:605-695-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP003195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily