Individual
ABBIE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-8222
(605) 719-4203
Mailing address
PO BOX 912882, DENVER, CO 80291-2882
(866) 765-0909
(855) 856-8520
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP000743
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609129709
BCBS SD
SD
05
—
1609129709
—
CO
05
—
1609129709
—
ND
05
—
1609129709
—
SD
01
—
P02096842
RR MEDICARE
SD
Enumeration date
10/26/2012
Last updated
12/18/2018
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