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General NPI Number Information
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NPI Number | 1053575092
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Entity Type | Individual
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Provider Name | WENDY ANN VETTER DO
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Gender | Female
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 06/06/2013
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Provider Practice Location Address
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Address Line | 2701 S KIWANIS AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57105-4252
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Country | US
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Telephone | 605-328-9100
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Fax | 605-328-9101
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Provider Business Mailing Address
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Address Line | PO BOX 5074
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City | SIOUX FALLS
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State | SD
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Zip | 57117-5074
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Country | US
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Telephone | 605-328-6585
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Fax | 605-328-6512
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5848
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 5848
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 8524
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License Number State | SD
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 8524
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License Number State | SD
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