Individual
ABBY LYNN BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1323 BIA ROUTE 4, FORT THOMPSON, SD 57339-1200
(605) 245-1516
Mailing address
202 N 6TH AVE, RELIANCE, SD 57569-2024
(605) 473-5059
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R036402
SD
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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