Individual
HEIDI WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
804 LEWIS ST, VERMILLION, SD 57069-3302
(605) 670-1496
Mailing address
804 LEWIS ST, VERMILLION, SD 57069-3302
(605) 670-1496
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R030141
SD
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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