Individual
JAYNE L NOVOTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 224-7070
(605) 224-2514
Mailing address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 224-7070
(605) 224-2514
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
417
SD
363AM0700X
Medical Physician Assistant
0417
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6828702
—
SD
Enumeration date
06/13/2006
Last updated
07/17/2012
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