| Kenzie Suzette Gant, DNP, FNP | |
| 
					111 Washington Ave Nw, Wagner, SD 57380-4300  | |
| (605) 384-3621 | |
| Not Available | 
| Full Name | Kenzie Suzette Gant | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 111 Washington Ave Nw, Wagner, South Dakota | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1750001970 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LP2300X | Nurse Practitioner - Primary Care | CP002187 (South Dakota) | Secondary | 
| 363LF0000X | Nurse Practitioner - Family | CP002187 (South Dakota) | Primary | 
| Entity Name | Wagner Indian Health Service Health Center | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1326066796 PECOS PAC ID: 6305758483 Enrollment ID: O20031105000746  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Kenzie Suzette Gant, DNP, FNP 610 Main Ave, Geddes, SD 57342-2206 Ph: (605) 212-8495  | Kenzie Suzette Gant, DNP, FNP 111 Washington Ave Nw, Wagner, SD 57380-4300 Ph: (605) 384-3621  | 
Lindsey Nedved, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611  | |
Carol Lee Stewart, DNP, APRN, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 513 3rd Street Sw, Wagner, SD 57380 Phone: 605-384-3611  | |
Ashley Marie Ruhaak, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611  | |
Jazmyn Soukup, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611  | |
Jessica M Vanderham, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611  | |
Brooke Lynn Plooster, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611 Fax: 605-384-5240  | |
Ryan Kocer, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611  |