MS. KATHERINE KILCHMANN BALTAZAR (NPI# 1043444672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043444672 |
| Entity Type | Individual |
| Full Name | MS. KATHERINE KILCHMANN BALTAZAR |
| Credential | PMHNP |
| Practice Address |
24276 166th Airport Rd Eagle Butte SD 57625-0476 |
| Mailing Address |
Po Box 1012 Eagle Butte SD 57625-1012 |
| Practice Telephone | 2679799524 |
| Mailing Telephone | 2679799524 |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2014-06-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
SP010164 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
24276 166TH AIRPORT RD |
| City | EAGLE BUTTE |
| State | SD |
| Zip Code | 57625-0476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124689245 | Shantel Norman | Physical Therapist | 24276 166th Airport Rd, Eagle Butte, SD 57625 | 2019-06-28 |
| 1689136251 | Sarah Seymour | Registered Nurse | 24276 166th Airport Rd, Eagle Butte, SD 57625 | 2019-04-03 |
| 1982003307 | Devany Loren Hall | Nurse's Aide | 24276 166th Airport Rd, Eagle Butte, SD 57625 | 2014-08-21 |
| 1255674768 | Christopher Allen Guggolz | Physical Therapist | 24276 166th Airport Rd, Eagle Butte, SD 57625 | 2013-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998359 | Jill M Marshall | Registered Nurse | 24279 166th St. Airport Road, Eagle Butte, SD 57625 | 2020-06-29 |
| 1871110890 | Stephen Andrew Williams | Registered Nurse | 24767 166th St, Eagle Butte, SD 57625 | 2020-06-26 |
| 1730706706 | Shannon Renee Brautigan | Registered Nurse | 24276 166th Street Airport Rd., Eagle Butte, SD 57625 | 2020-06-25 |
| 1598327827 | Lucy Manu | Pharmacist | 24276 166th Street; Airport Road, Eagle Butte, SD 57625 | 2019-07-08 |
| 1518429539 | Lisa Marie Brower | Registered Nurse | 24276 166th Street, Airport Rd., Eagle Butte, SD 57625 | 2019-04-01 |
| 1063976025 | Jeff Dixon | Pharmacist | Cheyenne River Health Center 24276 Airport Rd., 166th S, Eagle Butte, SD 57625 | 2019-01-24 |
| 1619455540 | Alycia Oster | Registered Nurse | 24276 166th St Airport Rd, Eagle Butte, SD 57625 | 2018-08-02 |
| 1447765987 | Deidra Monique Hall | Nurse's Aide | 211 S Spiel Court, Eagle Butte, SD 57625 | 2017-12-06 |
| 1295271070 | Cree Iron Cloud | Registered Nurse | #24276 Airport Rd, Eagle Butte, SD 57625 | 2017-01-17 |
| 1922452531 | Holly Mattern | Registered Nurse | 24276 166th Street Airport Rd, Eagle Bute, SD 57625 | 2016-04-20 |
| Find all providers in zip 57625 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669037099 | Progressing Forward Medical and Mental Health Services LLC | Nurse Practitioner | 611 Old Agency Dr Unit 134b, Sisseton, SD 57262-7224 | 2019-05-01 |
| 1962858985 | Lac Castor Wellness, LLC | Nurse Practitioner | 3213 W Main St, Rapid City, SD 57702-2314 | 2016-05-09 |
| 1790102549 | Tracy V Romey | Nurse Practitioner | 636 St. Anne St., Ste. 100, Rapid City, SD 57701 | 2014-03-18 |
| 1710266473 | Brenda Lenae Johnson | Nurse Practitioner | 306 4th St, Suite G, Brookings, SD 57006-1940 | 2011-08-12 |
| 1598920738 | Amber Nicole Janis | Nurse Practitioner | E. Hwy 18, 4500 Hospital Drive, Pine Ridge Indian Health Service Hospital, Pine Ridge, SD 57770-1201 | 2008-07-28 |
| 1700065208 | Marylou Mylant | Nurse Practitioner | 1011 11th St, Rapid City, SD 57701-3530 | 2007-10-31 |
| 1518021260 | Donna M. Linke | Nurse Practitioner | 39832 233rd St, Woonsocket, SD 57385-6522 | 2006-12-20 |
| 1437155132 | Family Institute of The Midwest | Nurse Practitioner | 520 W 22nd St, Sioux Falls, SD 57105-1702 | 2005-06-27 |
| 1790393825 | Anders Peterson | Nurse Practitioner | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2020-07-15 |
| 1609494483 | Hannah Otten | Nurse Practitioner | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2020-07-08 |
| Find all providers with the same taxonomy | ||||
| City | EAGLE BUTTE |
| Zip Code | 57625 |
Please comment or provide details below to improve the information on MS. KATHERINE KILCHMANN BALTAZAR.
| 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.