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Individual

MRS. JENNIFER L BIETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
708 8TH ST, ARMOUR, SD 57313-2102
(605) 724-2151
(605) 724-2310
Mailing address
41949 US HIGHWAY 18, TRIPP, SD 57376-7011
(605) 583-2900

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0489
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
23141
SIOUX VALLEY HEALTH PLAN
SD
01
49997104
BLUE CROSS
SD
01
6504
AVERA HEALTH PLANS
SD
05
6823890
SD
Enumeration date
06/14/2005
Last updated
12/06/2011
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