Individual
MS. VICKI BLAKE-NAFUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5348
(605) 747-5348
Mailing address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5348
(605) 747-5348
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0218
SD
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6820185
—
SD
Enumeration date
08/10/2006
Last updated
06/27/2018
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