Healthcare Provider Details

I. General information

NPI: 1881795946
Provider Name (Legal Business Name): LINDA MAE PUDENZ CNS, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 E 23RD ST
SIOUX FALLS SD
57105-2135
US

IV. Provider business mailing address

810 E 23RD ST PO BOX 5116
SIOUX FALLS SD
57105-2135
US

V. Phone/Fax

Practice location:
  • Phone: 605-331-5890
  • Fax: 605-336-3974
Mailing address:
  • Phone: 605-331-5890
  • Fax: 605-336-3974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License NumberR021526
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberCS004102
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: