Georgitte Gilman

Individual provider Active NPI General Practice Registered Nurse · Eagle Butte, SD

NPI 1780201624 · NPPES record last updated Jun 26, 2020

Key facts

NPI
1780201624
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
230419 (SC)
Practice address
24276 166TH Street
Eagle Butte, SD 57625
Phone
(605) 964-7724
NPI assigned
Jun 26, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
230419SCMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 230419 SC Yes

Addresses

Primary practice location

24276 166TH Street
Eagle Butte, SD 57625

Mailing address

24276 166TH Street
Eagle Butte, SD 57625

Other providers in Eagle Butte, SD

All providers in Eagle Butte, SD · General Practice Registered Nurse in South Dakota

Sources for this page

Verify at the official NPI Registry.