Provider Demographics
NPI:1386872539
Name:REIGSTAD, KATHERINE FAITH (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:FAITH
Last Name:REIGSTAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:901 15TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-2136
Mailing Address - Country:US
Mailing Address - Phone:320-979-7507
Mailing Address - Fax:
Practice Address - Street 1:101 WILLMAR AVE SW
Practice Address - Street 2:ACMC-WILLMAR
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201
Practice Address - Country:US
Practice Address - Phone:320-231-5010
Practice Address - Fax:320-231-5067
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN60877208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery