DR. STACY KRISTIN KOTALIK (NPI# 1164967774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164967774 |
| Entity Type | Individual |
| Full Name | DR. STACY KRISTIN KOTALIK |
| Credential | CNP |
| Practice Address |
409 Summit St Ste 2500 Yankton SD 57078-3739 |
| Mailing Address |
1104 W 8th St Yankton SD 57078-3306 |
| Practice Telephone | 6056551710 |
| Practice Fax Number | 6056551711 |
| Mailing Telephone | 6056657841 |
| Mailing Fax Number | 6056650546 |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2018-11-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CP001147 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1104 W 8th St, Yankton, SD 570783306 | 6056657841 | 6056650546 |
| Street Address |
409 SUMMIT ST STE 2500 |
| City | YANKTON |
| State | SD |
| Zip Code | 57078-3739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194228817 | Sacred Heart Health Services | Preventive Medicine | 409 Summit St Ste 2500, Yankton, SD 57078-3739 | 2018-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033719661 | Jime Lynne Rivera | Psychiatry & Neurology | 708 E 21st Street, Yankton, SD 57078 | 2020-11-01 |
| 1043617210 | Kenneth Tomek | Dietitian, Registered | 2100 Broadway St, Yankton, SD 57078 | 2014-12-03 |
| 1932530276 | Jacqueline Ann Kelley | Nurse Practitioner | 1105 West 8th Street, Mount Marty College, Yankton, SD 57078 | 2013-12-12 |
| 1124363130 | Susan Kay Taecker | Occupational Therapist | 1502 Jo Ln, Yankton, SD 57078 | 2012-12-02 |
| 1295865178 | Dr Jon C Baumann Dds PC | Dentist | 809 Belfast Street, Yankton, SD 57078 | 2007-03-07 |
| 1306989090 | Gregory Scott Erickson | Internal Medicine | 501 Summit, Yankton, SD 57078 | 2007-02-14 |
| 1104976356 | Pine Lane Estates LLC | Assisted Living Facility | 2905 Douglas Ave, Yankton, SD 57078 | 2007-01-11 |
| 1518029917 | Teresa M Henrickson | Counselor | 904 W 23rd St Ste 101, Heartland Psychological Services, Yankton, SD 57078 | 2006-12-14 |
| 1396805016 | Joseph G Blackinton | Psychologist | Heartland Psychological Services, 904 W 23rd St Ste 101, Yankton, SD 57078 | 2006-12-11 |
| 1942383468 | Deborah Jean Kachena | Social Worker | 610 W 23rd Street, Yankton, SD 57078 | 2006-10-21 |
| Find all providers in zip 57078 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972842409 | Carla Jean Steppat | Nurse Practitioner | 3515 Broadway Avenue, Yankton, SD 57078-7600 | 2013-02-04 |
| 1487723474 | Debra Ann Kolecka | Nurse Practitioner | 1005 W 8th St, Yankton, SD 57078-3389 | 2006-11-06 |
| 1447891973 | Emily Kate Wilken | Nurse Practitioner | 3515 Broadway Ave, Yankton, SD 57078-4917 | 2019-10-06 |
| 1023678075 | Elizabeth Ann Wortmann | Nurse Practitioner | 1104 W 8th St, Yankton, SD 57078-3306 | 2019-06-20 |
| 1386157709 | James Joseph Fillaus | Nurse Practitioner | 3515 Broadway Ave, Yankton, SD 57078-4917 | 2017-11-07 |
| 1619416526 | Amelia Jo Klimisch | Nurse Practitioner | 2001 Broadway Ave, Yankton, SD 57078 | 2017-02-13 |
| 1336683150 | Chelsie Promes | Nurse Practitioner | 1104 W 8th St, Yankton, SD 57078-3306 | 2016-12-13 |
| 1922540616 | Barbara De Witt | Nurse Practitioner | 3515 Broadway Ave, Yankton, SD 57078-4917 | 2016-11-10 |
| 1083073597 | Holly Haberman | Nurse Practitioner | 409 Summit St, Suite # 3400, Yankton, SD 57078-3734 | 2016-02-12 |
| 1558729046 | Katherine A Huff | Nurse Practitioner | 501 Summit St, Yankton, SD 57078-3855 | 2016-01-29 |
| Find all providers in YANKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.