Basic Information
| Provider Information | |||||||||
| NPI: | 1164142832 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GESENSWAY | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | KATHLEEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 318 WILLIAMS ST | ||||||||
| Address2: | |||||||||
| City: | DEADWOOD | ||||||||
| State: | SD | ||||||||
| PostalCode: | 577321116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512108249 | ||||||||
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| Practice Location | |||||||||
| Address1: | MONUMENT HEALTH ORTHOPEDIC & SPECIALTY HOSPITAL | ||||||||
| Address2: | 1635 CAREGIVER CIRCLE | ||||||||
| City: | RAPID CITY | ||||||||
| State: | SD | ||||||||
| PostalCode: | 57702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6057556100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2022 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.