Individual
GAIL SUE WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2200 13TH AVE, BELLE FOURCHE, SD 57717
(605) 892-2701
(605) 644-4197
Mailing address
353 FAIRMONT BLVD, ATTEN MEDICAL STAFF SERVICES, RAPID CITY, SD 57701-6000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0204
SD
363LF0000X
Family Nurse Practitioner
Primary
R018558
SD
Other
Enumeration date
06/03/2006
Last updated
01/24/2013
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