Individual
MRS. THERESA MARTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
640 FLORMANN STREET, SUITE 100, RAPID CITY, SD 57701
(605) 718-3100
(605) 718-3427
Mailing address
640 FLORMANN STREET, SUITE 100, RAPID CITY, SD 57701
(605) 718-3100
(605) 718-3427
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
CP000457
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6828420
—
SD
Enumeration date
10/12/2006
Last updated
07/08/2007
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