Healthcare Provider Details

I. General information

NPI: 1962340711
Provider Name (Legal Business Name): KYLLIE LINSTER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 FAIRMONT BLVD
RAPID CITY SD
57701-7375
US

IV. Provider business mailing address

3611 ANGEL WAY
RAPID CITY SD
57703-4501
US

V. Phone/Fax

Practice location:
  • Phone: 605-755-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number200430
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: