Individual
DESTINY BULTENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-2300
Mailing address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-2300
(605) 755-3510
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
R051099
SD
163WX0200X
Oncology Registered Nurse
R051099
SD
363LF0000X
Family Nurse Practitioner
Primary
CP003749
SD
Other
Enumeration date
06/20/2024
Last updated
08/06/2025
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