Individual
LINDA JANIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
US HIGHWAY 18, PINE RIDGE, SD 57770-1201
(605) 867-5131
Mailing address
PO BOX 1201, PINE RIDGE, SD 57770-1201
(605) 867-5131
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P008845
SD
282N00000X
General Acute Care Hospital
P008845
SD
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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