Individual
LISA JORGENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 S CLIFF AVE, SIOUX FALLS, SD 57105-1007
(605) 322-4425
Mailing address
1325 S CLIFF AVE, SIOUX FALLS, SD 57105-1007
(605) 322-4425
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
CP000532
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568460772
HOSPITAL
SD
Enumeration date
01/21/2012
Last updated
01/21/2012
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