Healthcare Provider Details

I. General information

NPI: 1235155474
Provider Name (Legal Business Name): SHERRY LEE LULF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 34 & 47
FORT THOMPSON SD
57339-0200
US

IV. Provider business mailing address

101 S 3RD AVE
RELIANCE SD
57569-2012
US

V. Phone/Fax

Practice location:
  • Phone: 605-245-1502
  • Fax: 605-245-2384
Mailing address:
  • Phone: 605-473-0221
  • Fax: 605-245-2384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR026808
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: