Healthcare Provider Details

I. General information

NPI: 1275788960
Provider Name (Legal Business Name): ANGELA KAY GAIKOWSKI NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2008
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 S MAIN ST
ABERDEEN SD
57401-7071
US

IV. Provider business mailing address

205 ORCHARD DRIVE
SISSETON SD
57262-2398
US

V. Phone/Fax

Practice location:
  • Phone: 605-250-1200
  • Fax: 605-250-0999
Mailing address:
  • Phone: 605-698-7681
  • Fax: 605-698-3493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP000886
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCP000886
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR222645-5
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: