Healthcare Provider Details

I. General information

NPI: 1134682933
Provider Name (Legal Business Name): DAYLON DUANE WIGART RN MSN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W ELM AVE
LINTON ND
58552-2100
US

IV. Provider business mailing address

111 W ELM AVE
LINTON ND
58552-2100
US

V. Phone/Fax

Practice location:
  • Phone: 701-254-4531
  • Fax:
Mailing address:
  • Phone: 701-254-4511
  • Fax: 701-254-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP001557
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: