Individual
AMY S JURACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
809 JACKSON ST, BURKE, SD 57523-2065
(605) 775-2631
Mailing address
814 JACKSON ST, BURKE, SD 57523-0358
(605) 775-2631
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP000467
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0851370001
DME
—
05
—
6829160
—
SD
Enumeration date
05/27/2006
Last updated
10/25/2022
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