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Individual

KENZIE SUZETTE GANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, FNP

Contact information

Practice address
111 WASHINGTON AVE NW, WAGNER, SD 57380-4300
(605) 384-3621
Mailing address
610 MAIN AVE, GEDDES, SD 57342-2206
(605) 212-8495

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP002187
SD
363LP2300X
Primary Care Nurse Practitioner
CP002187
SD

Other

Enumeration date
08/29/2022
Last updated
03/27/2024
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