MEDICARE: DR. KATHERINE ANNE DEGEN MD

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
1	207V00000X	Obstetrics & Gynecology Physician	R70613	AZ

General Provider Information

NPI Number	:	1588992051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE ANNE DEGEN MD

Provider Business Mailing Address
First Line	:	677 CATHEDRAL DRIVE
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-7389
Country	:	US
Telephone Number	:	605-343-9224
Fax Number	:	605-342-1359

Provider Business Practice Location Address
First Line	:	677 CATHEDRAL DRIVE
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-7389
Country	:	US
Telephone Number	:	605-343-9224
Fax Number	:	605-342-1359

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2009
Last Update Date	:	12/14/2012

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