Basic Information
| Provider Information | |||||||||
| NPI: | 1588992051 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEGEN | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 677 CATHEDRAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | RAPID CITY | ||||||||
| State: | SD | ||||||||
| PostalCode: | 577017389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053439224 | ||||||||
| FaxNumber: | 6053421359 | ||||||||
| Practice Location | |||||||||
| Address1: | 677 CATHEDRAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | RAPID CITY | ||||||||
| State: | SD | ||||||||
| PostalCode: | 577017389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053439224 | ||||||||
| FaxNumber: | 6053421359 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2009 | ||||||||
| LastUpdateDate: | 12/14/2012 | ||||||||
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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 | 207V00000X | R70613 | AZ | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.