Individual
STEPHEN D ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-1000
Mailing address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7350
(605) 430-3109
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000463
SD
367500000X
Certified Registered Nurse Anesthetist
R031003
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5751232
—
SD
Enumeration date
09/30/2006
Last updated
08/11/2014
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