Amy Lee Kester-Mabon, RN

Primary specialty

College Health Registered NurseTaxonomy code 163WC1400X

License

R33583 Issued in ND

Practice address

105 Simrall Blvd
Bottineau, ND 58318-1159

Phone

(701) 228-5460

Fax

(701) 228-5499

NPI assigned

Sep 6, 2012

Last updated

Sep 6, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dakota College at Bottineau

  • Dental Assistant
  • Minot, ND
  • NPI 1528931532
  NPD (past)

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1578812459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SIMRALL BLVD",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181159",
            "telephone_number": "701-228-5460",
            "fax_number": "701-228-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SIMRALL BLVD",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181159",
            "telephone_number": "701-228-5460",
            "fax_number": "701-228-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTER-MABON",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R33583",
            "primary": false
        },
        {
            "code": "163WC1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, College Health",
            "state": "ND",
            "license": "R33583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dean Herman
• Leah S. Hermanson-Faul
• J & J Enterprises Inc (Thompson Drug)
• Kelly Jensen
• Evelyn Johnson
• Jennifer Jolene Kittleson
• Kathleen Kittleson
• Kyleen Kitzman
• Rebekah Klebe
• Mark E Koivula, FNP-C

• College Health Registered Nurse in Bottineau, ND
• Providers in Bottineau, ND by specialty
• College Health Registered Nurse in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.