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Individual

MS. KATIE DONNELL MANDLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
24276 AIRPORT RD, EAGLE BUTTE, SD 57625-8021
(605) 964-7724
Mailing address
PO BOX 1544, EAGLE BUTTE, SD 57625-1544
(314) 288-9935

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
130108
MO

Other

Enumeration date
05/21/2020
Last updated
05/21/2020
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