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General NPI Number Information
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NPI Number | 1427097260
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Entity Type | Individual
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Provider Name | TONYA R. VENHUIZEN MATT CNP
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Gender | Female
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 10/16/2018
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Provider Practice Location Address
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Address Line | 1301 S. CLIFF AVE STE 601
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1032
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Country | US
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Telephone | 605-322-6930
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Fax | 605-322-6931
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Provider Business Mailing Address
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Address Line | PO BOX 86370
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City | SIOUX FALLS
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State | SD
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Zip | 57118-6370
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Country | US
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Telephone | 605-322-7510
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Fax | 605-322-6475
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CP000141
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License Number State | SD
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