Healthcare Provider Details
I. General information
NPI: 1760968085
Provider Name (Legal Business Name): SARAH ANN TROMBETTA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/19/2018
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 S LLOYD ST STE W190
ABERDEEN SD
57401-4509
US
IV. Provider business mailing address
PO BOX 1460
ABERDEEN SD
57402-1460
US
V. Phone/Fax
- Phone: 605-225-0025
- Fax:
- Phone: 605-622-2876
- Fax: 605-622-2804
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | R040588 |
| License Number State | SD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | CP001409 |
| License Number State | SD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: