Basic Information
| Provider Information | |||||||||
| NPI: | 1144292848 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAETZE | ||||||||
| FirstName: | VERONICA | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 86370 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571186370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1417 S. CLIFF AVE. | ||||||||
| Address2: | STE. 401 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053228920 | ||||||||
| FaxNumber: | 6053228919 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2006 | ||||||||
| LastUpdateDate: | 10/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | 1765 | SD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
ID Information
| ID | Type | State | Issuer | Description | 1511121 | 05 | IA | MEDICAID | 160055444 | 01 | SD | RR MEDICARE | OTHER | 25927 | 01 | SD | SANFORD HEALTH PLANS | OTHER | 6200443 | 05 | SD | MEDICAID | 33581,33582,33583 | 01 | IA | BLUE CROSS | OTHER | 9315 | 01 | SD | MIDLANDS CHOICE | OTHER | 047T8GA | 01 | MN | CC SYSTEMS/ BLUE PLUS | OTHER | HP28269 | 01 | SD | HEALTHPARTNERS | OTHER | 0008502 | 01 | SD | BLUE CROSS | OTHER | 46022474316 | 05 | NE | MEDICAID | 0702557 | 01 | SD | MEDICA | OTHER | 1765 | 01 | SD | DAKOTACARE | OTHER | 521590100 | 05 | MN | MEDICAID | 790189 | 01 | SD | ARAZ/ AMERICA'S PPO | OTHER | 57105M003 | 01 | SD | WPS TRICARE | OTHER | 492S1GA/ 047T8GA | 01 | MN | BLUE CROSS | OTHER | AH9131019048 | 01 | SD | PREFERRED ONE | OTHER |