Individual
TRAVIS JOHN VACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
1325 S CLIFF AVE, SIOUX FALLS, SD 57105-1007
(605) 322-8000
Mailing address
27056 468TH AVE, TEA, SD 57064-8003
(605) 212-8161
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP002912
SD
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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