Provider Demographics
NPI:1871022764
Name:DARGATZ, PAIGE ELIZABETH (NP-C)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:DARGATZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 8TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-3242
Mailing Address - Country:US
Mailing Address - Phone:605-725-4772
Mailing Address - Fax:605-725-4777
Practice Address - Street 1:2120 8TH AVE NE
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-3242
Practice Address - Country:US
Practice Address - Phone:605-725-4772
Practice Address - Fax:605-725-4777
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP001222363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily