Individual
LENN ISLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
2112 W 13TH ST, SIOUX FALLS, SD 57104-3900
(605) 360-0964
Mailing address
2112 W 13TH ST, SIOUX FALLS, SD 57104-3900
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P010401
SD
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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