Individual
LISA MARIE SUNDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 347-2511
Mailing address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 347-2511
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P008506
SD
Other
Enumeration date
05/09/2025
Last updated
05/09/2025
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