Individual
MRS. JIRINA FEDELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 719-4011
Mailing address
13859 LH RD, FAIRBURN, SD 57738-5040
(706) 945-4895
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
095902
GA
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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