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Contact Information

JENNA WICKERSHAM, DO
100 MAC LN
PIERRE, SD57501
 Phone:
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for JENNA WICKERSHAM · (Female)

NPI Number 1538579271
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/02/2014
Last updated 06/26/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • SD License # 0085
  • SD License # 10716
Hospital affiliation(s)
  • ST MARY'S HOSPITAL - (Acute Care)
    801 E SIOUX
    PIERRE, SD 57501
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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