Individual
KRISTINA R BOETEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
506 1ST AVE SE, WATERTOWN, SD 57201-4499
(605) 886-8482
(605) 884-4300
Mailing address
506 1ST AVE SE, WATERTOWN, SD 57201-4499
(605) 886-8482
(605) 884-4300
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP001496
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP001496
STATE LICENSE
SD
Enumeration date
11/02/2018
Last updated
11/02/2018
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