Elizabeth Blears

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Sioux Falls, SD

NPI 1376953158 · NPPES record last updated May 2, 2014

Key facts

NPI
1376953158
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1400 W 22ND St
Sioux Falls, SD 57105-1554
Phone
(605) 357-1391
NPI assigned
May 2, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161207001859 TX Order and Referring Only - General Surgery
Practitioner - General Surgery
7012135379

National Provider Directory

Medicare enrollment (NPD)
Yes

Interoperability endpoints

  • Direct secure messaging: eblears2931875@direct.trinity-health.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1400 W 22ND St
Sioux Falls, SD 57105-1554

Mailing address

393 Fairvew Avenue
Winnetka, IL 60093

Other providers in Sioux Falls, SD

All providers in Sioux Falls, SD · Student in an Organized Health Care Education/Training Program in South Dakota

Sources for this page

Verify at the official NPI Registry.