Basic Information
| Provider Information | |||||||||
| NPI: | 1063488310 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HURLEY | ||||||||
| FirstName: | KRISTEN | ||||||||
| MiddleName: | DAWN | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 S MINNESOTA AVE | ||||||||
| Address2: | STE 100 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571053762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E 23RD ST | ||||||||
| Address2: | STE. 200 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571052122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053223035 | ||||||||
| FaxNumber: | 6053223036 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2006 | ||||||||
| LastUpdateDate: | 12/18/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | CP000443 | SD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 248477 | 01 | SD | MIDLANDS CHOICE | OTHER | 45377 | 01 | SD | SANFORD HEALTH PLAN | OTHER | 4994353 | 01 | SD | BLUE CROSS | OTHER | 0122537 | 01 | SD | MEDICA | OTHER | 2391538 | 01 | SD | ARAZ/ AMERICA'S PPO | OTHER | 285P3HU | 01 | MN | CC SYSTEMS/ BLUE PLUS | OTHER | 57105AH07 | 01 | SD | WPS TRICARE | OTHER | 6828150 | 05 | SD | MEDICAID | 46022474342 | 05 | NE | MEDICAID | 678061045689 | 01 | SD | PREFERRED ONE | OTHER | 92411422911 | 01 | MN | PRIMEWEST | OTHER | 0536219 | 05 | IA | MEDICAID | HP58136 | 01 | SD | HEALTHPARTNERS | OTHER | 998138100 | 05 | MN | MEDICAID | 285P3HU | 01 | MN | BLUE CROSS | OTHER | 370624200 | 01 | SD | DEPT OF LABOR | OTHER | 9249262 | 01 | SD | DAKOTACARE | OTHER |