Individual
KORIE KAE PRAVECEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
825 E 8TH ST, SUITE 1, WINNER, SD 57580-2634
(605) 842-2626
Mailing address
28260 318TH AVE, COLOME, SD 57528-6412
(605) 840-0166
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP000870
SD
Other
Enumeration date
07/08/2014
Last updated
10/22/2014
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