Healthcare Provider Details

I. General information

NPI: 1679081350
Provider Name (Legal Business Name): ABBY JO VIERECK FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 S. LAKE AVENUE SUITE 201
SIOUX FALLS SD
57104-0569
US

IV. Provider business mailing address

PO BOX 5039
SIOUX FALLS SD
57117-5039
US

V. Phone/Fax

Practice location:
  • Phone: 605-312-5350
  • Fax: 605-312-8928
Mailing address:
  • Phone: 605-312-5350
  • Fax: 605-312-8928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCP001331
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP001331
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: