Individual
STACY WACHHOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 W 22ND ST STE 301, SIOUX FALLS, SD 57105-1503
(605) 328-7700
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-7700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
114358
NE
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
CP002673
SD
Other
Enumeration date
08/22/2022
Last updated
01/15/2026
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