Healthcare Provider Details

I. General information

NPI: 1508702036
Provider Name (Legal Business Name): MARCHETTI RDS HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 OAK TREE LANE
NORTH SIOUX CITY SD
57049
US

IV. Provider business mailing address

PO BOX 799
NORTH SIOUX CITY SD
57049-0799
US

V. Phone/Fax

Practice location:
  • Phone: 605-659-3965
  • Fax:
Mailing address:
  • Phone: 605-659-3965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DARREN G STOUB
Title or Position: MANAGER
Credential: PA-C
Phone: 605-659-3965