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Individual

RYAN KOCER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
513 3RD ST SW, WAGNER, SD 57380-9675
(605) 384-3611
Mailing address
PO BOX 280, WAGNER, SD 57380
(605) 384-3418
(605) 384-5240

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP001437
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CP001437
SOUTH DAKOTA BOARD OF NURSING LICENSURE
SD
Enumeration date
09/08/2018
Last updated
11/15/2018
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