Provider Demographics
NPI:1053803361
Name:KAPPES, EMILY JOY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JOY
Last Name:KAPPES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JOY
Other - Last Name:SWANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 347
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:SD
Mailing Address - Zip Code:57445-0347
Mailing Address - Country:US
Mailing Address - Phone:605-397-2363
Mailing Address - Fax:605-397-4403
Practice Address - Street 1:1205 N 1ST ST
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:SD
Practice Address - Zip Code:57445-2329
Practice Address - Country:US
Practice Address - Phone:605-397-2363
Practice Address - Fax:605-397-4403
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6430183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist