Individual
BEVERLY JANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
EAST HWY 18, PINE RIDGE, SD 57770
(605) 867-5131
Mailing address
EAST HWY 18, PINE RIDGE, SD 57770
(605) 867-5131
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P006306
SD
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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