Individual
AMANDA LOUISE FELLBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1112 S LAKE AVENUE SUITE 201, SIOUX FALLS, SD 57104
(605) 312-5350
(605) 312-8928
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 312-5350
(605) 312-8928
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
CP002165
SD
Other
Enumeration date
10/21/2021
Last updated
05/23/2022
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