KATHY A KIRKEBY (NPI# 1225059561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225059561 |
Entity Type | Individual |
Full Name | KATHY A KIRKEBY |
Other Name | KATHY A WUSSOW |
Credential | PA-C |
Practice Address |
820 4th St N Fargo ND 58122-0001 |
Practice Telephone | 7012347544 |
Practice Fax Number | 7012347577 |
Mailing Telephone | 7012347544 |
Mailing Fax Number | 7012347577 |
Enumeration Date | 2006-07-22 |
Last Update Date | 2012-11-21 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PAC0130 | ND | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | 430620100 | 05 | |
ND | 71174 | 05 |
Street Address |
820 4TH ST N |
City | FARGO |
State | ND |
Zip Code | 58122-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922025907 | Anu G Gaba | Internal Medicine | 820 4th St N, Fargo, ND 58122-0001 | 2006-07-16 |
1023629631 | Pauline Aamodt | Genetic Counselor, MS | 820 4th St N, Fargo, ND 58102-4539 | 2020-08-17 |
1710507561 | Brittany Nicole Twiss | Dietitian, Registered | 820 4th St N, Fargo, ND 58102-4539 | 2020-04-22 |
1366092801 | Sanford Medical Center Fargo | Hospice Care, Community Based | 820 4th St N, Fargo, ND 58102-4539 | 2019-09-17 |
1154807741 | Morgan Rinke | Nurse Practitioner | 820 4th St N, Fargo, ND 58102-4539 | 2018-07-17 |
1497269583 | Ethan Joseph Brenna | Genetic Counselor, MS | 820 4th St N, Fargo, ND 58102-4539 | 2017-11-28 |
1265885867 | Carrie Pfaff | Nurse Practitioner | 820 4th St N, Fargo, ND 58102-4539 | 2016-07-19 |
1316315385 | Sharri M Lacher | Clinical Nurse Specialist | 820 4th St N, Fargo, ND 58102-4539 | 2015-09-09 |
1487022885 | John Roll | Clinical Nurse Specialist | 820 4th St N, Fargo, ND 58102-4539 | 2015-09-02 |
1699181495 | Kirk David Wyatt | Pediatrics | 820 4th St N, Fargo, ND 58102-4539 | 2014-07-01 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184142747 | Kayla Estepp | Internal Medicine | 737 Broadway North, Fargo, ND 58122 | 2017-09-05 |
1376091793 | Paul Mckay | Physical Therapist | 801 Broadway N., Fargo, ND 58122 | 2016-09-14 |
1801290150 | Mark Noah | Physical Therapist | 1720 South University, Fargo, ND 58122 | 2014-10-15 |
1245633486 | Diana Palm | Physical Therapist | 1720 University Drive South, Fargo, ND 58122 | 2014-10-02 |
1447696406 | Mohamad Imam | Internal Medicine | 801 Broadway North, Fargo, ND 58122 | 2013-05-17 |
1457615155 | Chantee Seung Gruenhagen | Nurse Practitioner | 737 North Broadway, Sanford Urology Clinic, Fargo, ND 58122 | 2012-06-27 |
1457594079 | Manisha Balhara | Specialist | 2400 32nd Avenue S, Fargo, ND 58122 | 2009-04-13 |
1578536728 | Shelby A Terstriep | Internal Medicine | 820 4 Street North, Fargo, NC 58122 | 2006-02-08 |
1295229946 | Christopher Hinh | Student in an Organized Health Care Education/Training Program | 801 Broadway North, Fargo, ND 58122 | 2018-06-17 |
1558854539 | Suchita Kotnala | Family Medicine | 737 Broadway North, Fargo, ND 58122 | 2018-06-13 |
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Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205015633 | Jamie M Brown | Physician Assistant | 1711 Gold Dr S, Suite 170, Fargo, ND 58103-6416 | 2007-11-02 |
1790703353 | Mary Jane Kadry | Physician Assistant | 1121 Westrac Dr S Ste 204, Fargo, ND 58103-2385 | 2006-07-18 |
1861419723 | Catherine M Garvey | Physician Assistant | 2801 University Dr S, Fargo, ND 58103-6029 | 2006-07-16 |
1881148005 | Kali Luecke | Physician Assistant | 301 Np Ave N, Fargo, ND 58102-4835 | 2016-08-04 |
1215480009 | Jason Byrne Smith | Physician Assistant | 801 Broadway N, Fargo, ND 58102-3641 | 2016-07-27 |
1659758381 | Sarah Winter | Physician Assistant | 1702 University Dr S, Fargo, ND 58103-4940 | 2015-05-01 |
1861801763 | Lisa Lynn Froemke | Physician Assistant | 3838 12th Ave N, Fargo, ND 58102-2931 | 2014-08-05 |
1033525365 | Kathryn Gray | Physician Assistant | 301 Np Ave N, Fargo, ND 58102-4835 | 2014-07-08 |
1326462490 | Shannon Lynn Gullingsrud | Physician Assistant | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2014-02-10 |
1467722702 | Yan Tesch | Physician Assistant | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2012-01-04 |
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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.