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Individual

DOREEN M BOOMSMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.N.P.-MS

Contact information

Practice address
455 KANSAS AVE SE, HURON, SD 57350-2522
(605) 352-8767
(605) 352-8784
Mailing address
PO BOX 1411, HURON, SD 57350-1411
(605) 352-8767
(605) 352-8784

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
249
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0006283
WELLMARK
SD
01
500007017
RAILROAD MEDICARE
SD
05
6826750
SD
01
9237904
DAKOTACARE
SD
Enumeration date
06/20/2005
Last updated
11/03/2009
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