Healthcare Provider Details

I. General information

NPI: 1639506181
Provider Name (Legal Business Name): KALI RAE ABERLE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 06/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 2ND AVE EAST
MCLAUGHLIN SD
57642-5764
US

IV. Provider business mailing address

PO BOX 879
MC LAUGHLIN SD
57642-0879
US

V. Phone/Fax

Practice location:
  • Phone: 605-823-4458
  • Fax:
Mailing address:
  • Phone: 605-823-4458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR041676
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberR041676
License Number StateSD
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP001573
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: