Individual
JASON PHILIP WETSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-1000
Mailing address
2577 LEOLA LN, RAPID CITY, SD 57703-6674
(605) 209-0373
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP003031
SD
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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