MEDICARE: NICHOLE QUIST

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	246XS1301X	Sonography Specialist/Technologist Cardiovascular	53696

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	53696	OTHER		ARDMS

General Provider Information

NPI Number	:	1952729618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLE QUIST

Provider Business Mailing Address
First Line	:	6709 S MINNESOTA AVE
Second Line	:	203
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2592
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6709 S MINNESOTA AVE
Second Line	:	203
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2592
Country	:	US
Telephone Number	:	605-274-2525
Fax Number	:	605-274-0620

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

Provider Enumeration Date	:	03/31/2014
Last Update Date	:	04/15/2026

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Directions to “ NICHOLE QUIST ” Practice Location

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