Individual
MRS. KELLY MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4400 W 69TH ST, SIOUX FALLS, SD 57108-8170
(605) 322-4065
Mailing address
2216 S GRINNELL AVE, SIOUX FALLS, SD 57106-5106
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP002475
SD
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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