Healthcare Provider Details

I. General information

NPI: 1306211040
Provider Name (Legal Business Name): CYNTHIA ANN STOCKS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONUMENT HEALTH FAMILY MEDICINE 640 FLORMANN STREET
RAPID CITY SD
57701
US

IV. Provider business mailing address

MONUMENT HEALTH FAMILY MEDICINE 640 FLORMANN STREET
RAPID CITY SD
57701
US

V. Phone/Fax

Practice location:
  • Phone: 605-755-3300
  • Fax: 605-755-3129
Mailing address:
  • Phone: 605-755-3300
  • Fax: 605-755-3129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSD-CNP CP000994
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: