Healthcare Provider Details

I. General information

NPI: 1629763990
Provider Name (Legal Business Name): BRYNNA JANSEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 S MARION RD
SIOUX FALLS SD
57106-3646
US

IV. Provider business mailing address

717 N WILLOW CREEK AVE
SIOUX FALLS SD
57110-4046
US

V. Phone/Fax

Practice location:
  • Phone: 605-322-1020
  • Fax:
Mailing address:
  • Phone: 320-221-3077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0715
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: