Kendra E Lone Elk, REGISTERED NURSE

Individual provider Active NPI Registered Nurse · Pine Ridge, SD

NPI 1679735575 · NPPES record last updated Sep 19, 2012

Key facts

NPI
1679735575
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
SDRN R026838 (SD)
Practice address
East Hiway 18 Airport Road
Ost Health Administration
Pine Ridge, SD 57770-5011
Phone
(605) 867-1704
Fax
(605) 867-2063
NPI assigned
Jul 1, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
SDRN R026838SDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Oglala Sioux Tribe Health Administration Past Accepting new patients
Oglala Sioux Tribe Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X SDRN R026838 SD Yes

Addresses

Primary practice location

East Hiway 18 Airport Road
Ost Health Administration
Pine Ridge, SD 57770-5011

Mailing address

PO Box 5011
East Hiway 18 Airport Road
Pine Ridge, SD 57770-5011
Phone (605) 867-1704

Other identifiers

IdentifierTypeStateIssuer
460439437OtherSDNPI NUMBER

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.