Individual
CARRIE J DYLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
123 19TH STREET NE, WATERTOWN, SD 57201
(605) 886-8482
(605) 884-4300
Mailing address
PO BOX 1030, WATERTOWN, SD 57201
(605) 886-0123
(605) 886-5447
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0485
SD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1052055
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5200010
—
SD
05
—
6823410
—
SD
Enumeration date
06/16/2006
Last updated
09/11/2025
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