Basic Information
| Provider Information | |||||||||
| NPI: | 1104871292 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ENGELMANN | ||||||||
| FirstName: | TERRY | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5074 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571175074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053287700 | ||||||||
| FaxNumber: | 6053287775 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 W 22ND ST | ||||||||
| Address2: | STE 301 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571057702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053287700 | ||||||||
| FaxNumber: | 6053287775 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 06/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | CM000022 | SD | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 367A00000X | R1436615 | MN | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367A00000X | R016975 | SD | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.