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Individual

ELLEN T WENGERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
705 N SIOUX POINT RD, SUITE 100, DAKOTA DUNES, SD 57049-5091
(605) 217-5500
(605) 217-5515
Mailing address
705 N SIOUX POINT RD, SUITE 100, DAKOTA DUNES, SD 57049-5091
(605) 217-5500
(605) 217-5515

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
A070238
IA
363LF0000X
Family Nurse Practitioner
Primary
CP000911
SD

Other

Enumeration date
09/18/2014
Last updated
11/20/2014
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