Bailey B Tetrault, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CP003084 Issued in SD

Practice address

113 Comanche Rd # R0Ad
Fort Meade, SD 57741-1002

Phone

(605) 347-2511

NPI assigned

Jan 23, 2024

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

Credentials

Certified Nurse Practitioner

State licenses

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1639930902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 ABSAROKA ST",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577833313",
            "telephone_number": "605-478-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 COMANCHE RD # R0AD",
            "city": "FORT MEADE",
            "state": "SD",
            "postal_code": "577411002",
            "telephone_number": "605-347-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETRAULT",
        "first_name": "BAILEY",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP003084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Swaney
• Victoria Faith Tappe, LCSW
• Shelley Lynn Tech, RN
• Lydia Marie Teegerstrom, AUD
• Cali Ann Terveen, RN
• Richard Francis Thelen
• Jessica Pearl Thomas
• Phillip Victor Thompson, PHARMD.
• Mark C Thorson, MSN,RN
• Carrie Jo Thurman

• Family Nurse Practitioner in Fort Meade, SD
• Providers in Fort Meade, SD by specialty
• Family Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.