MEDICARE: SHERYL L. MARCKSTADT CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0312	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487658837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERYL L. MARCKSTADT CNP

Provider Business Mailing Address
First Line	:	5027 S BUR OAK PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2228
Country	:	US
Telephone Number	:	605-271-9000
Fax Number	:	605-271-9001

Provider Business Practice Location Address
First Line	:	5027 S BUR OAK PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2228
Country	:	US
Telephone Number	:	605-271-9000
Fax Number	:	605-271-9001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	04/18/2022

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