Katie Donnell Mandle, REGISTERED NURSE

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

130108 Issued in MO

Practice address

24276 Airport Rd
Eagle Butte, SD 57625-8021

Phone

(605) 964-7724

NPI assigned

May 21, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1164045308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1544",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576251544",
            "telephone_number": "314-288-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24276 AIRPORT RD",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576258021",
            "telephone_number": "605-964-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDLE",
        "first_name": "KATIE",
        "middle_name": "DONNELL",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "MO",
            "license": "130108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Elaine Long
• Alex Looking Horse
• Latilia Deanne Mack, PHARM.D.
• Carmen Kathryn Maher Kraft, RDH
• Ann Maher, LRD
• Lucy Manu, PHARMACIST
• Jill M Marshall, RN
• Heather Leigh Martin, R.N.
• Mildred Martinez-Santos, RN
• Medicine Wheel Village

• Emergency Registered Nurse in Eagle Butte, SD
• Providers in Eagle Butte, SD by specialty
• Emergency Registered Nurse in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.