Healthcare Provider Details

I. General information

NPI: 1225097199
Provider Name (Legal Business Name): ALEEN M. GOLIS MS, APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEEN M. BRAY NP

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

2210 JENNINGS AVE
HOT SPRINGS SD
57747-1829
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 TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP000497
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: