Healthcare Provider Details

I. General information

NPI: 1730829235
Provider Name (Legal Business Name): DAWN HARTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W 49TH ST STE 218
SIOUX FALLS SD
57105-6509
US

IV. Provider business mailing address

2500 W 49TH ST STE 218
SIOUX FALLS SD
57105-6509
US

V. Phone/Fax

Practice location:
  • Phone: 605-214-2581
  • Fax: 877-874-2463
Mailing address:
  • Phone: 605-214-2581
  • Fax: 877-874-2463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR021145
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: