Healthcare Provider Details

I. General information

NPI: 1780484543
Provider Name (Legal Business Name): HOLLY MONDAIN CECH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HOLLY MONDAIN SELLAND RN

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W 22ND ST
SIOUX FALLS SD
57105-1305
US

IV. Provider business mailing address

305 S MAPLE ST
WORTHING SD
57077-2051
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-3230
  • Fax:
Mailing address:
  • Phone: 605-777-9045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR028690
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: