Individual
KAITLIN M ATWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 720-7449
Mailing address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 720-7449
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0772
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6832630
—
SD
Enumeration date
03/07/2011
Last updated
04/17/2024
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