| Simply Gorgeous, Llc | |
|
1028 29th St Se Watertown SD 57201-9120 | |
| (605) 878-2888 | |
| (605) 878-0361 |
| Full Name | Simply Gorgeous, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1028 29th St Se, Watertown, South Dakota |
| Authorized Official Name and Position | Melissa Jean Magstadt (OWNER) |
| Authorized Official Contact | 6058782888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Simply Gorgeous, Llc 1028 29th St Se Watertown SD 57201-9120 Ph: (605) 878-2888 | Simply Gorgeous, Llc 1028 29th St Se Watertown SD 57201-9120 Ph: (605) 878-2888 |
| NPI Number | 1750092151 |
|---|---|
| Provider Enumeration Date | 12/07/2022 |
| Last Update Date | 02/28/2023 |
| Medicare PECOS PAC ID | 8022483254 |
|---|---|
| Medicare Enrollment ID | O20230331000661 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750092151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Melissa J Magstadt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093794596 PECOS PAC ID: 8628053428 Enrollment ID: I20040623001429 |
| Provider Name | Allison Judeen Decurtins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497363113 PECOS PAC ID: 5496173908 Enrollment ID: I20200916000041 |
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