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JENNIFER L BIETZ, PA-C – NPI #1225033681
Medical

NPI Profile for JENNIFER L BIETZ in ARMOUR, SD.

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Contact Information

JENNIFER L BIETZ, PA-C
708 8TH ST
ARMOUR, SD  57313-2102
 Phone: 605-724-2151
 Fax: 605-724-2310
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Medical

 363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JENNIFER L BIETZ · (Female)

NPI Number 1225033681
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 06/14/2005
Last updated 12/06/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • SD License # 0489
  • SD Medicaid 6823890
  • SD Other 6504 AVERA HEALTH PLANS
  • SD Other 49997104 BLUE CROSS
  • SD Other 23141 SIOUX VALLEY HEALTH PLAN
Hospital affiliation(s)
  • AVERA QUEEN OF PEACE - (Acute Care)
    525 N FOSTER
    MITCHELL, SD 57301
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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