Healthcare Provider Details

I. General information

NPI: 1962496752
Provider Name (Legal Business Name): ROSE MARIE HOITEN CNM,CNP,IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S BYRON BLVD
CHAMBERLAIN SD
57325-9741
US

IV. Provider business mailing address

44674 256TH ST
MONTROSE SD
57048-6002
US

V. Phone/Fax

Practice location:
  • Phone: 605-234-6551
  • Fax:
Mailing address:
  • Phone: 605-769-0807
  • Fax: 605-363-3211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA-116582
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1040
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP000449 FAMILY
License Number StateSD
# 4
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCM000046
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: