Individual
LIBERTY ANN DERBY GOODSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
100 LAKE TRAVERSE DR, SISSETON, SD 57262-7046
(605) 698-7606
Mailing address
100 LAKE TRAVERSE DR, SISSETON, SD 57262-7046
(605) 698-7606
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L13475
ND
Other
Enumeration date
07/11/2013
Last updated
07/11/2013
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