Individual
BAILEY JO KECKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24337 US HIGHWAY 212, EAGLE BUTTE, SD 57625-7770
(605) 964-8000
Mailing address
PO BOX 860, EAGLE BUTTE, SD 57625-0860
(605) 295-3497
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R047564
SD
363LF0000X
Family Nurse Practitioner
Primary
CP002540
SD
Other
Enumeration date
12/16/2018
Last updated
12/13/2022
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