Healthcare Provider Details

I. General information

NPI: 1154237402
Provider Name (Legal Business Name): PAIGE ELIZABETH MEHLBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 W 49TH ST
SIOUX FALLS SD
57106-2322
US

IV. Provider business mailing address

3401 W 49TH ST
SIOUX FALLS SD
57106-2322
US

V. Phone/Fax

Practice location:
  • Phone: 605-328-8670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1025
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: