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NPI Profile for SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION in SISSETON, SD.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner | |
Dietitian, Registered |
133V00000X | 71 | Registered Dietitian or Nutrition Professional |
| NPI Number | 1629858519 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/29/2023 | |
| Last updated | 02/22/2024 - About 2 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION