KATHERINE GANNON KIESEL (NPI# 1699305862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699305862 |
| Entity Type | Individual |
| Full Name | KATHERINE GANNON KIESEL |
| Credential | NP |
| Practice Address |
2067 Charlie Hall Blvd Charleston SC 29414-5834 |
| Mailing Address |
4975 Lacross Rd Ste 158 North Charleston SC 29406-6532 |
| Practice Telephone | 8435732535 |
| Practice Fax Number | 8435732534 |
| Mailing Telephone | 8435732535 |
| Mailing Fax Number | 8433715507 |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
23598 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2067 CHARLIE HALL BLVD |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29414-5834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770700759 | Coastal Pediatric Associates, P.a. | Psychologist | 2067 Charlie Hall Blvd, Charleston, SC 29414-5834 | 2007-04-19 |
| 1255979738 | Gabrielle Amarante | Nurse Practitioner | 2067 Charlie Hall Blvd, Charleston, SC 29414-5834 | 2019-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902444508 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 3865 West Ashley Circle, Charleston, SC 29414 | 2019-12-13 |
| 1215440169 | Christine Michelle Delcioppo | Nurse Practitioner | 2085 Henry Tecklenburg Dr Fl 2or2, Charleston, SC 29414 | 2017-11-14 |
| 1871013508 | Carolyn Sorenson | Assistant Behavior Analyst | 2218 Hunter Creek Dr, Charleston, SC 29414 | 2017-06-23 |
| 1205387354 | Rachel Klatt | Physical Therapist | 2230 Ashley Crossing Dr., Charleston, SC 29414 | 2016-10-24 |
| 1295286912 | Mary M Butler | Physical Therapy Assistant | 2230 Ashley Crossing Drive, Charleston, SC 29414 | 2016-10-18 |
| 1295104982 | Charlene Barbot | Registered Nurse | 3741 Clover St, Charleston, SC 29414 | 2015-09-23 |
| 1720467525 | Sasha M. Perez | Family Medicine | 3030 Ashley Town Center Dr Ste 102a, Charleston, SC 29414 | 2015-05-26 |
| 1104226240 | Angela Mcinvale | Counselor | 3030 Ashley Town Center Dr., Bldg. B-203, Charleston, SC 29414 | 2014-08-26 |
| 1659790087 | Catherine Jefferson Vanderwerker | Physical Therapist | 3019 Saintsbury Cove Dr, Charleston, SC 29414 | 2014-04-14 |
| 1104266741 | Elizabeth A Burguieres | Psychiatry & Neurology | Scdmh- Charleston Telepsychiatry Office, 706 Orleans Rd, Charleston, SC 29414 | 2013-06-27 |
| Find all providers in zip 29414 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912515511 | Naajah Hughes | Nurse Practitioner | 96 Jonathan Lucas Street Csb 428 Msc 608, Charleston, SC 29425-0001 | 2020-07-20 |
| 1528476793 | Kacie Owens | Nurse Practitioner | 830 Pennslyvania Avenue, Suite 103, Charleston, WV 25302-3389 | 2014-07-31 |
| 1124214895 | Elizabeth Zimmerman Thelan | Nurse Practitioner | 2051 Charlie Hall Blvd., Charleston, SC 29414 | 2007-09-17 |
| 1255979738 | Gabrielle Amarante | Nurse Practitioner | 2067 Charlie Hall Blvd, Charleston, SC 29414-5834 | 2019-12-16 |
| 1396388393 | Jessica Kristen Gardner | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8900 | 2019-10-22 |
| 1114426814 | Erin Hill | Nurse Practitioner | 1871 Savage Rd, Charleston, SC 29407-4726 | 2018-02-08 |
| 1528566932 | Mckenzie Clark | Nurse Practitioner | 51 Nassau St, Charleston, SC 29403-5513 | 2018-01-31 |
| 1255842910 | Vanessa Lee Adams | Nurse Practitioner | 165 Ashley Ave, Charleston, SC 29425-8905 | 2017-10-20 |
| 1720524556 | Christine Lee Butler | Nurse Practitioner | 1941 Savage Rd Ste 100e, Charleston, SC 29407-4788 | 2017-01-18 |
| 1487197844 | Colleen Cusick Yazdi | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8908 | 2016-12-02 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29414 |
Please comment or provide details below to improve the information on KATHERINE GANNON KIESEL.
| 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.