Individual
REBECCA JO MOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
756 E LAKE STR, LAKE ANDES, SD 57356-0279
(605) 487-7878
(605) 487-9566
Mailing address
PO BOX 279, LAKE ANDES, SD 57356-0279
(605) 487-7878
(605) 487-9566
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP000512
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4992777
WELLMARK PARKSTON
SD
01
—
4992778
WELLMARK LAKE ANDES
SD
05
—
6829710
—
SD
05
—
6829712
—
SD
01
—
9251967
DAKOTACARE
SD
01
—
CP000512
NURSE PRACTITIONER
SD
Enumeration date
09/11/2007
Last updated
08/09/2012
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