Makenzie Ruthann Smith
Individual provider Active NPI Licensed Practical Nurse · Sioux Falls, SD
NPI 1104565894 · NPPES record last updated Jun 1, 2022
Key facts
- NPI
- 1104565894
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- P013404 (SD)
- Practice address
- 2000 S Summit Ave
Sioux Falls, SD 57105-2727 - Phone
- (605) 336-0503
- NPI assigned
- Jun 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P013404 | SD | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Behavioral Healthcare | Current |
Accepting new patients |
Locations
2000 S Summit Ave
Sioux Falls, SD 57105
Phone (605) 336-0503
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | P013404 | SD | Yes |
Addresses
Primary practice location
2000 S Summit Ave
Sioux Falls, SD 57105-2727
Mailing address
2000 S Summit Ave
Sioux Falls, SD 57105-2727
Phone (605) 336-0503
Other providers in Sioux Falls, SD
- Kenneth C Smith
- Kevin Smith
- Kristine Carol Smith
- Lana J Smith
- Leslie Elizabeth Smith
- Margaret A Smith
- Mary Ellen Smith
- Melissa Ann Smith
- Michael Craig Smith
- NA Smith
All providers in Sioux Falls, SD · Licensed Practical Nurse in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.