Individual
NICOLE L STETHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1325 S CLIFF AVE, SIOUX FALLS, SD 57105-1007
(605) 322-2000
(605) 322-2036
Mailing address
PO BOX 5045, PLAZA 2 P.F.S., SIOUX FALLS, SD 57117-5045
(605) 322-2000
(605) 322-2036
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5671
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100474
BLUE CROSS OF SD
SD
05
—
0597831
—
IA
05
—
156124300
—
MN
01
—
254P5ST
MN BC PROVIDER #
MN
05
—
46022474331
—
NE
01
—
5671
DAKOTACARE
—
05
—
6631210
—
SD
Enumeration date
07/29/2006
Last updated
04/19/2013
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