Individual
MADELYN RAE PONTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
400 22ND AVE, BROOKINGS, SD 57006-2450
(605) 697-9500
Mailing address
400 22ND AVE, BROOKINGS, SD 57006-2450
(605) 697-9500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP002167
SD
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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