Healthcare Provider Details

I. General information

NPI: 1891194320
Provider Name (Legal Business Name): CASSIE APPLEGATE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 02/08/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6015 MOUNT RUSHMORE RD STE 2
RAPID CITY SD
57701-8962
US

IV. Provider business mailing address

2713 W SAINT ANNE ST
RAPID CITY SD
57702-4271
US

V. Phone/Fax

Practice location:
  • Phone: 605-343-9224
  • Fax: 605-342-1359
Mailing address:
  • Phone: 605-858-1269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCM000066
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberRN0195978
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: