MEDICARE: MS. SHAUNA LEIGH FEHRENBACH APRN-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	200809	SD

General Provider Information

NPI Number	:	1881528651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHAUNA LEIGH FEHRENBACH APRN-CNP

Provider Business Mailing Address
First Line	:	1056 NORTH CREEK DRIVE
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57703
Country	:	US
Telephone Number	:	605-773-3478
Fax Number	:	605-773-6810

Provider Business Practice Location Address
First Line	:	1056 NORTH CREEK DRIVE
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57703
Country	:	US
Telephone Number	:	605-773-3478
Fax Number	:	605-773-6810

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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