Individual
HEATHER BURULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1323 BIA RT 4, BOX 200, FORT THOMPSON, SD 57339
(605) 245-1576
Mailing address
25299 DEER VALLEY RD, RELIANCE, SD 57569-3000
(605) 245-1576
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R047343
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN R047343
BOARD OF NURSING
SD
Enumeration date
09/01/2016
Last updated
09/01/2016
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