Individual provider · Type 1 NPI
Gail Sue Wild, CNP
Family Nurse Practitioner · Belle Fourche, SD
NPI number
1629016480
Active
Practice location
2200 13th Ave
Belle Fourche, SD 57717
Fax (605) 644-4197
Mailing address
353 Fairmont Blvd, Atten Medical Staff Services
Rapid City, SD 57701-6000
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0204 (SD) |
| Family Nurse Practitioner Primary | 363LF0000X | R018558 (SD) |
Family Nurse Practitioner: Definition to come...
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About NPI 1629016480
Gail Sue Wild, CNP's National Provider Identifier is 1629016480, issued on Jun 3, 2006. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Belle Fourche, SD. The record was last updated on Jan 24, 2013.