Julie Ann Hericks

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

P005788 Issued in SD

Practice address

3200 Canyon Lake Dr
Rapid City, SD 57702-8114

Phone

(605) 355-2234

Fax

(605) 355-2512

NPI assigned

Sep 22, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1467123190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 CANYON LAKE DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028114",
            "telephone_number": "605-355-2234",
            "fax_number": "605-355-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CANYON LAKE DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028114",
            "telephone_number": "605-355-2234",
            "fax_number": "605-355-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERICKS",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "SD",
            "license": "P005788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Henry, MT
• Matthew Aaron Henry, PA
• Noni Ann Henry
• Tamara Henzlik, MNT
• John Wesley Herbst, MD
• Mason Alexander Hericks
• Kelley Hermann, CSW
• Beth Hermanson, CNP
• Sharon Hermeling, PT
• Luis Alonso Hernandez Mejia, M.D

• Clinical Nurse Specialist in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Clinical Nurse Specialist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.