Healthcare Provider Details

I. General information

NPI: 1235926460
Provider Name (Legal Business Name): EVELYN SHULTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N 5TH ST
HOT SPRINGS SD
57747-1480
US

IV. Provider business mailing address

500 N 5TH ST
HOT SPRINGS SD
57747-1480
US

V. Phone/Fax

Practice location:
  • Phone: 605-745-2000
  • Fax:
Mailing address:
  • Phone: 605-745-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number247654
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: