Healthcare Provider Details

I. General information

NPI: 1467225458
Provider Name (Legal Business Name): DENISE MARIE BARAGAR CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 MINNESOTA ST
RAPID CITY SD
57701-6219
US

IV. Provider business mailing address

15574 LONESOME DOVE ST
BOX ELDER SD
57719-8139
US

V. Phone/Fax

Practice location:
  • Phone: 605-791-0602
  • Fax:
Mailing address:
  • Phone: 605-415-6618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number18678
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCP003054
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR050518
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: