Healthcare Provider Details

I. General information

NPI: 1720920416
Provider Name (Legal Business Name): SHELBY FIDELER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 S CLIFF AVE
SIOUX FALLS SD
57105-1007
US

IV. Provider business mailing address

325 W LAQUINTA CIR
SIOUX FALLS SD
57108-2409
US

V. Phone/Fax

Practice location:
  • Phone: 605-881-9954
  • Fax:
Mailing address:
  • Phone: 605-881-9954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6294
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: