Individual
LYNELLE KILMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
504 E MONROE ST, RAPID CITY, SD 57701-1400
(605) 394-6665
(605) 355-3508
Mailing address
504 E MONROE ST, RAPID CITY, SD 57701-1400
(605) 394-6665
(605) 355-3508
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0272
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5350060
—
SD
Enumeration date
08/11/2006
Last updated
07/08/2007
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