Individual
DAVID NISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
908 N WEST AVE, SIOUX FALLS, SD 57104-5722
(605) 367-4293
Mailing address
908 N WEST AVE, SIOUX FALLS, SD 57104-5722
(605) 367-4293
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5180100
—
SD
Enumeration date
04/11/2007
Last updated
07/08/2007
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