Healthcare Provider Details

I. General information

NPI: 1730090143
Provider Name (Legal Business Name): MAYA LYNN PUMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAYA LYNN FEENSTRA

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5919 S REMINGTON PL STE 200
SIOUX FALLS SD
57108-5266
US

IV. Provider business mailing address

5919 S REMINGTON PL STE 200
SIOUX FALLS SD
57108-5266
US

V. Phone/Fax

Practice location:
  • Phone: 605-499-7477
  • Fax:
Mailing address:
  • Phone: 605-499-7477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number201948
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR054636
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: