Individual
MISS ELLEN PIETSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24276 AIRPORT RD, EAGLE BUTTE, SD 57625
(605) 964-0705
Mailing address
PO BOX 882, EAGLE BUTTE, SD 57625-0882
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
R042935
SD
Other
Enumeration date
10/16/2014
Last updated
10/16/2014
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