Basic Information
Provider Information
NPI: 1386697670
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIEBINK
FirstName: PATRICIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HEGG
OtherFirstName: PATRICIA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 5074
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571175074
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 300 S BYRON BLVD
Address2:  
City: CHAMBERLAIN
State: SD
PostalCode: 573259741
CountryCode: US
TelephoneNumber: 6052346551
FaxNumber: 6052347260
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 11/15/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X3398SDY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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