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Individual

LISA PICOTTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2500
Mailing address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2500

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RO34042
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0140070
SD
05
5549050
SD
Enumeration date
12/11/2009
Last updated
12/11/2009
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