Healthcare Provider Details

I. General information

NPI: 1427297266
Provider Name (Legal Business Name): JAIMEE ALLISEN MCGUIRE DNP, RN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAIMEE ALLISEN GIVENS

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 08/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 1ST STREET
WANBLEE SD
57577
US

IV. Provider business mailing address

P.O. BOX 290 210 1ST STREET
WANBLEE SD
57577
US

V. Phone/Fax

Practice location:
  • Phone: 605-462-6155
  • Fax:
Mailing address:
  • Phone: 605-462-6155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2006002520
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: