Individual
MRS. MARY C MOUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
E HWY 18, PINE RIDGE, SD 57770
(605) 867-3145
(605) 867-3307
Mailing address
BOX 1201, HWY 18 EAST, PINE RIDGE, SD 57770
(605) 867-3145
(605) 867-3307
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R022007
SD
163WC1500X
Community Health Registered Nurse
Primary
R022007
SD
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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