Individual
BETH ANDREA MCQUISTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1325 S CLIFF AVE, SIOUX FALLS, SD 57105-1007
(605) 322-2754
(605) 322-2727
Mailing address
PO BOX 5045, ATTN: PFS PROV ENROLLMENT, SIOUX FALLS, SD 57117-5045
(605) 322-2754
(605) 322-2727
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R027438
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427221449
WELLMARK BCBS OF SD
SD
01
—
1427221449
MN BCBS
—
05
—
1427221449
—
MN
01
—
46022474348
NEBRASKA MEDICAID
NE
05
—
5755750
—
SD
01
—
9260694
DAKOTACARE
SD
01
—
P00671163
RAILROAD MEDICARE
SD
Enumeration date
04/10/2008
Last updated
03/30/2015
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