Le'Ann Bender, PA-C
Individual provider Active NPI Physician Assistant · Whitehorse, SD
NPI 1720149388 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720149388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0404 (SD)
- Practice address
- 151 Main Street
Whitehorse, SD 57661-0151 - Phone
- (605) 733-2133
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0404 | SD | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0404 | SD | Yes |
Addresses
Primary practice location
151 Main Street
Whitehorse, SD 57661-0151
Mailing address
PO Box 704
Mobridge, SD 57601-0704
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.