Organization
MIND BODY CONNECTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KOUPAL DNP-FNP, QMHP, PMHNP (BUSINESS OWNER)
(605) 431-3388
Entity
Organization
Contact information
Practice address
8000 BLACK HAWK RD STE 4, BLACK HAWK, SD 57718-3315
(605) 431-3388
Mailing address
8000 BLACK HAWK RD STE 4, BLACK HAWK, SD 57718-3315
(605) 431-3388
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
09/07/2023
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