Healthcare Provider Details

I. General information

NPI: 1528031499
Provider Name (Legal Business Name): DEBORAH KULLERD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 154
NEMO SD
57759-0154
US

IV. Provider business mailing address

PO BOX 154
NEMO SD
57759-0154
US

V. Phone/Fax

Practice location:
  • Phone: 605-645-2185
  • Fax:
Mailing address:
  • Phone: 605-645-2185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number3763
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3763
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: