Ladonna Raye Bender, CNP

Individual provider Active NPI Nurse Practitioner · Belle Fourche, SD

NPI 1124069075 · NPPES record last updated Jan 27, 2009

Key facts

NPI
1124069075
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
CP000432 (SD)
Practice address
2200 13TH Ave
Belle Fourche, SD 57717-2215
Phone
(605) 892-2701
Fax
(605) 723-0210
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP000432SDMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP000432 SD Yes

Addresses

Primary practice location

2200 13TH Ave
Belle Fourche, SD 57717-2215

Mailing address

2200 13TH Ave
Belle Fourche, SD 57717-2215
Phone (605) 892-2701

Other providers in Belle Fourche, SD

All providers in Belle Fourche, SD · Nurse Practitioner in South Dakota

Sources for this page

Verify at the official NPI Registry.