Individual
CYNTHIA JANE PALLESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
105 S STATE ST, STE 113, ABERDEEN, SD 57401-4501
(605) 622-4000
(605) 626-3399
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R141881-1
MN
363L00000X
Nurse Practitioner
R36847
ND
363LF0000X
Family Nurse Practitioner
Primary
R017439
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19855
—
ND
01
—
8Y4021
BCBS PVN
TX
01
—
MP0470550
CONTROLLED SUBSTANCE CERT
SD
01
—
R017439
SD RN LICENSE NUMBER
SD
01
—
R141881-1
MN RN LICENSURE
MN
Enumeration date
11/03/2006
Last updated
09/08/2016
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