Healthcare Provider Details

I. General information

NPI: 1477926558
Provider Name (Legal Business Name): PATRICIA SUE HEINRICY DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2015
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 S MARION RD
SIOUX FALLS SD
57106-3646
US

IV. Provider business mailing address

1200 S 7TH AVE
SIOUX FALLS SD
57105-0998
US

V. Phone/Fax

Practice location:
  • Phone: 605-322-1010
  • Fax: 605-322-1011
Mailing address:
  • Phone: 605-782-8305
  • Fax: 605-336-1677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP001006
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: