Raegan Dewilde

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1780226084

Raegan Dewilde is a Physician Assistant in Fairview, Oklahoma. Qualified in 2020, 6 years ago. Practices with Fairview Regional Medical Center Authority, a 4-clinician group and accepts Medicare assignment.

Years since qualifying: 6
In the registry since: 2019
Specialties on file: 2

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Fairview, OK

No coordinates on file. Search this address in Google Maps

Specialties & licences

Medical Physician Assistant (primary)	Taxonomy 363AM0700X
Student in an Organized Health Care Education/Training Program	Taxonomy 390200000X

Record details

NPI number	1780226084
Entity type	Individual (Type 1)
Gender	Female
Sole proprietor	Yes
NPI enumerated	October 8, 2019
Last updated in NPPES	June 8, 2022
Certification date	June 8, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialty	PHYSICIAN ASSISTANT
Medical school	OTHER
Graduated	2020 (6 years in practice)
Group practice	Fairview Regional Medical Center Authority — 4 clinicians
Accepts Medicare assignment	Yes — accepts the Medicare-approved amount
Practice locations	3 on file with Medicare