Individual
STEPHANIE KREIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
922 22ND AVE S, BROOKINGS, SD 57006-2830
(605) 697-1900
(605) 697-1919
Mailing address
922 22ND AVE S, BROOKINGS, SD 57006-2830
(605) 697-1900
(605) 697-1919
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001682
IA
363A00000X
Physician Assistant
Primary
0612
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6828410
—
SD
Enumeration date
05/18/2006
Last updated
05/09/2008
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