Heidi Sue Blue

Individual provider Active NPI Athletic Trainer · Huron, SD

NPI 1366651283 · NPPES record last updated May 27, 2010

Key facts

NPI
1366651283
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
0239 (SD)
Practice address
20132 409TH Ave
Huron, SD 57350-6303
Phone
(605) 461-9277
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0239SDMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0239 SD Yes

Addresses

Primary practice location

20132 409TH Ave
Huron, SD 57350-6303

Mailing address

20132 409TH Ave
Huron, SD 57350-6303
Phone (605) 461-9277

Other providers in Huron, SD

All providers in Huron, SD · Athletic Trainer in South Dakota

Sources for this page

Verify at the official NPI Registry.