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Contact Information

SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
114 LAKE TRAVERSE DR STE 102
SISSETON, SD57262-7046
 Phone: 833-674-3444
 Fax: 605-303-5295
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
 

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION

NPI # 1629858519
LBN Legal business name SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
Authorized official ELISE JOHNSON - (SWO TRIBAL HEALTH DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 09/29/2023
Last updated 02/22/2024 - About 2 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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