Individual
MARY TICKNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNAP
Contact information
Practice address
910 E 20TH ST, SIOUX FALLS, SD 57105-1012
(605) 334-6730
Mailing address
820 S TORREY PINE LN, SIOUX FALLS, SD 57110-7649
(605) 929-3633
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR001191
SD
Other
Enumeration date
07/05/2024
Last updated
07/05/2024
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