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Organization
SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
Active
Organization
SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
Active
Parent organization
SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
Other names
SISSETON-WAHPETON OYATE ASNIYAPI FIELD HEALTH CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
Authorized official
ELISE JOHNSON MPH (SWO TRIBAL HEALTH DIRECTOR)
(605) 698-8315
Entity
Organization
Contact information
Practice address
114 LAKE TRAVERSE DR STE 102, SISSETON, SD 57262-7046
(833) 674-3444
(605) 303-5295
Mailing address
PO BOX 509, SISSETON, SD 57262-0509
(605) 742-3697
(605) 698-4239
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/29/2023
Last updated
02/22/2024
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