Individual
JENNIFER NICOLE WHITING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1325 S CLIFF AVE, AVERA MCKENNAN ANESTHESIOLOGY, SIOUX FALLS, SD 57105-1007
(605) 322-2754
(605) 322-2727
Mailing address
PO BOX 5045, ATTN: PFS, PROV ENROLLMENT, SIOUX FALLS, SD 57117-5045
(605) 322-6428
(604) 322-6499
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000742
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881910891
BCBS MN
MN
01
—
1881910891
WELLMARK BCBS SD - TRICARE TRIWEST
—
05
—
1881910891
—
IA
05
—
1881910891
—
MN
05
—
2000117
—
SD
05
—
46022474348
—
NE
01
—
9292965
DAKOTACARE
—
Enumeration date
04/15/2010
Last updated
12/10/2014
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