Individual
BUNPENG VONGKAENCHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5009 S LOUISE AVE, SIOUX FALLS, SD 57108
(605) 799-1273
Mailing address
5009 S LOUISE AVE, SIOUX FALLS, SD 57108-2268
(605) 610-8522
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP001197
SD
363LF0000X
Family Nurse Practitioner
R040266
SD
Other
Enumeration date
06/18/2017
Last updated
05/05/2020
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