Individual
KAILEE MCFADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
674 DENALI DR, BOX ELDER, SD 57719-8510
(402) 570-9986
Mailing address
674 DENALI DR, BOX ELDER, SD 57719-8510
(402) 570-9986
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3747A0650X
N/A
SD
Enumeration date
12/01/2020
Last updated
12/01/2020
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