Individual
STEPHANIE M IDEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 W 69TH ST, SIOUX FALLS, SD 57108
(605) 336-0635
(605) 271-0543
Mailing address
201 W 69TH ST, SIOUX FALLS, SD 57108-2403
(605) 336-0635
(605) 271-0543
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0868
SD
Other
Enumeration date
06/04/2013
Last updated
05/02/2019
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