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Contact Information

HOLLY MATTERN
24276 166TH STREET AIRPORT RD
EAGLE BUTE, SD57625
 Phone: 605-964-0666
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for HOLLY MATTERN · (Female)

NPI Number 1922452531
Status Active
Credentials
Entity Individual
Enumeration date 04/20/2016
Last updated 08/05/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • SD License # 002442
  • SD License # R038851
Hospital affiliation(s) Not Available
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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