Individual
JENNA ANNE WEIDENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-8222
Mailing address
20170 WAGON BOX RD, WHITEWOOD, SD 57793-6436
(605) 484-4634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
04/02/2025
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