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NPI Code Detail

MEDICARE: ENCOMPASS WELLNESS

MEDICARE: ENCOMPASS WELLNESS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1033999057
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENCOMPASS WELLNESS
Provider Business Mailing Address
First Line : 4700 S TECHNOPOLIS DR STE 2A
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-4247
Country : US
Telephone Number : 605-740-0414
Fax Number :
Provider Business Practice Location Address
First Line : 4301 W 57TH ST STE 160
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57108-2288
Country : US
Telephone Number : 605-740-0414
Fax Number :
Authorized Official
Title or Position : CREDENTIALER
Name : KRYSTA FISCHER
Credential :
Telephone Number : 712-539-1212
Provider Enumeration Date : 10/05/2023
Last Update Date : 11/13/2023

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Directions to “ENCOMPASS WELLNESS ” Practice Location

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