Individual
MIKAYLA CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-1000
Mailing address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-1000
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
CP002273
SD
Other
Enumeration date
01/21/2022
Last updated
01/21/2022
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