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General NPI Number Information
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NPI Number | 1699663575
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Entity Type | Individual
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Provider Name | JORI ANNE ELLENBECKER
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Gender | Female
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 910 E 20TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1012
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Country | US
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Telephone | 605-334-6730
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Fax |
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Provider Business Mailing Address
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Address Line | 4511 E 53RD ST UNIT A
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City | SIOUX FALLS
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State | SD
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Zip | 57110-5305
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Country | US
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Telephone | 605-370-4581
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | R054035
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License Number State | SD
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