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NPI Code Detail

MEDICARE: KATHERINE LYFORD WILGERS NP

MEDICARE:   KATHERINE LYFORD WILGERS  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerCP001757SD

General Provider Information

NPI Number : 1487293692
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE LYFORD WILGERS NP
Provider Business Mailing Address
First Line : 115 N 7TH ST STE 6
Second Line :
City : SPEARFISH
State : SD
Zip : 57783-2710
Country : US
Telephone Number : 605-645-0100
Fax Number : 605-717-1009
Provider Business Practice Location Address
First Line : 310 S 26TH ST STE 1
Second Line :
City : SPEARFISH
State : SD
Zip : 57783-3355
Country : US
Telephone Number : 605-580-7358
Fax Number : 605-559-0321
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2020
Last Update Date : 01/20/2026

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