Individual
TY ANN MCCAULEY
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
(701) 202-1703
Mailing address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R042739
SD
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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