Brannon Tyshaun Cousin
Individual provider Active NPI Athletic Trainer · Rapid City, SD
NPI 1811663263 · NPPES record last updated Aug 17, 2021
Key facts
- NPI
- 1811663263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 28 Hillcrest Dr
Rapid City, SD 57701-3654 - Phone
- (605) 454-7910
- NPI assigned
- Aug 17, 2021
- Sex
- Male
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
28 Hillcrest Dr
Rapid City, SD 57701-3654
Mailing address
28 Hillcrest Dr
Rapid City, SD 57701-3654
Phone (605) 454-7910
Other providers in Rapid City, SD
- Cornerstone Caregiving East LLC
- Tammy Cornwell
- Teresa E Corrigan
- Sarah Anne Coulter Danner
- Heather Courage
- Samuel W Cowgill
- Bryan Cowles
- Cox Mental Health and Wellness
- Adriane Marie Cox
- Tara K Cox
All providers in Rapid City, SD · Athletic Trainer in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2021. 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.