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General NPI Number Information
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NPI Number | 1437043668
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Entity Type | Individual
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Provider Name | MARISSA EICH CNP
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Gender | Female
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 6100 S LOUISE AVE STE 1110
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City | SIOUX FALLS
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State | SD
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Zip | 57108-6030
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Country | US
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Telephone | 605-504-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 3004 S LANA DR
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City | SIOUX FALLS
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State | SD
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Zip | 57106-6068
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | CP003708
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License Number State | SD
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