Healthcare Provider Details

I. General information

NPI: 1881528651
Provider Name (Legal Business Name): SHAUNA LEIGH FEHRENBACH APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1056 NORTH CREEK DRIVE
RAPID CITY SD
57703
US

IV. Provider business mailing address

1056 NORTH CREEK DRIVE
RAPID CITY SD
57703
US

V. Phone/Fax

Practice location:
  • Phone: 605-773-3478
  • Fax: 605-773-6810
Mailing address:
  • Phone: 605-773-3478
  • Fax: 605-773-6810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200809
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: