Individual
MISS RENEE L BLAHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1210 W 18TH ST STE G01, SIOUX FALLS, SD 57104-4651
(605) 328-2663
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 312-9802
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0499
SD
363A00000X
Physician Assistant
1962
WI
363A00000X
Physician Assistant
9828
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396700449
—
MN
Enumeration date
04/20/2006
Last updated
03/10/2022
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