Individual
DIANE COON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
353 FAIRMONT BLVD., RAPID CITY, SD 57701
(605) 719-2300
(605) 719-2310
Mailing address
353 FAIRMONT BLVD, ATTEN MEDICAL STAFF SERVICES, RAPID CITY, SD 57701-6000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP000289
SD
363L00000X
Nurse Practitioner
RO17512
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040589
WELLMARK
SD
01
—
500027052
RR MEDICARE
SD
05
—
6823420
—
SD
Enumeration date
09/27/2006
Last updated
01/03/2013
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