KATHLEEN M LOGAN (NPI# 1699752089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699752089 |
| Entity Type | Individual |
| Full Name | KATHLEEN M LOGAN |
| Credential | M.D. |
| Practice Address |
555 E Broadway Ave Ste 204 Jackson WY 83001-8640 |
| Mailing Address |
Po Box 428 Jackson WY 83001-0428 |
| Practice Telephone | 3077394818 |
| Practice Fax Number | 8883295701 |
| Mailing Telephone | 3077394818 |
| Mailing Fax Number | 8883295701 |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2018-09-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
11343A | WY | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
25358 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | ENROLLED | 05 | |
| MN | 237717900 | 05 | |
| WI | 35207600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 1st St Sw, Rochester, MN 559050001 | 5072842511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407314347 | Kathleen Logan | Registered Nurse | 4582 Lake Rd, Williamson, NY 14589-9732 | 2019-03-11 |
| 1548534175 | Kathleen P Logan | Nurse Anesthetist, Certified Registered | 360 Broadway, Bangor, ME 04401 | 2012-02-29 |
| 1316153042 | Kathleen Logan | Nurse Practitioner | 801 17th St Ne, Community of Hope At Family Health and Birth Center, Washington, DC 20002-7200 | 2007-05-16 |
| Street Address |
555 E BROADWAY AVE STE 204 |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-8640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992047682 | Nils Charles Westfall | Psychiatry & Neurology | 555 E Broadway Ave Ste 204, Jackson, WY 83001-8640 | 2013-03-21 |
| 1295850014 | Jeff Decker | Counselor | 555 E Broadway Ave Ste 204, Jackson, WY 83001-8640 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871932194 | Saurabh Bipin Bhardwaj | Psychiatry & Neurology | 2500 N State St # H814, Jackson, MS 39216-4500 | 2013-06-19 |
| 1548421795 | Edgar Draper | Psychiatry & Neurology | 2419 Lake Circle, Jackson, MS 39211 | 2008-06-20 |
| 1689854523 | Robert J Brock Md PC | Psychiatry & Neurology | 480 S Cache, Jackson, WY 83001-0941 | 2007-11-08 |
| 1821285610 | Michaela Puno Weller | Psychiatry & Neurology | 3855 Cooper St, Charles Egeler Reception & Guidance Center, Jackson, MI 49201-7547 | 2007-09-26 |
| 1285846774 | Debra E Rodgers Md Pa | Psychiatry & Neurology | 175 Olympia Flds, Jackson, MS 39211-2510 | 2007-05-04 |
| 1497808463 | Virginia J Payne | Psychiatry & Neurology | 1675 Lakeland Dr Ste 200, Jackson, MS 39216-4843 | 2007-01-20 |
| 1952453854 | Marcelita A Bermudez | Psychiatry & Neurology | 4502 Hwy 951, Jackson, LA 70748 | 2007-01-18 |
| 1225180938 | Joe C Scoggin Sr. | Psychiatry & Neurology | 1675 Lakeland Drive, 200 Riverhill Tower, Jackson, MS 39216-4852 | 2007-01-16 |
| 1649352337 | Michael E Stept | Psychiatry & Neurology | 1675 Lakeland Dr, Ste 200, Jackson, MS 39216-4843 | 2006-10-20 |
| 1881702710 | Andrew Charles Bishop | Psychiatry & Neurology | 971 Lakeland Dr Ste 654, Jackson, MS 39216-4605 | 2006-08-29 |
| Find all providers in JACKSON | ||||
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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.