Healthcare Provider Details

I. General information

NPI: 1770938540
Provider Name (Legal Business Name): KARI HARGENS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2016
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 W 18TH ST
SIOUX FALLS SD
57117
US

IV. Provider business mailing address

7329 W 61ST ST
SIOUX FALLS SD
57106-5920
US

V. Phone/Fax

Practice location:
  • Phone: 605-333-1000
  • Fax:
Mailing address:
  • Phone: 605-366-2370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberSD-RN R038489
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberSD-CRN CR000912
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: