Teresa Annette Blacksmith, RN

Individual provider Active NPI Registered Nurse · Pine Ridge, SD

NPI 1639338122 · NPPES record last updated Jun 9, 2008

Key facts

NPI
1639338122
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R027661 (SD)
Practice address
US Hwy 18
Pine Ridge IHS
Pine Ridge, SD 57770
Phone
(605) 867-3007
NPI assigned
Jun 9, 2008
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R027661SDMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R027661 SD Yes

Addresses

Primary practice location

US Hwy 18
Pine Ridge IHS
Pine Ridge, SD 57770

Mailing address

IHS N-21
Pine Ridge, SD 57770
Phone (605) 867-2581

Other providers in Pine Ridge, SD

All providers in Pine Ridge, SD · Registered Nurse in South Dakota

Sources for this page

Verify at the official NPI Registry.