Healthcare Provider Details

I. General information

NPI: 1053015313
Provider Name (Legal Business Name): ASHLEY STRUBE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W 22ND ST
SIOUX FALLS SD
57105-1554
US

IV. Provider business mailing address

1420 W 22ND ST STE 307
SIOUX FALLS SD
57105-1507
US

V. Phone/Fax

Practice location:
  • Phone: 605-333-7197
  • Fax:
Mailing address:
  • Phone: 218-770-8296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0733
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: