Basic Information
Provider Information
NPI: 1821742610
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NIEHAUS
FirstName: ERIN
MiddleName: CATHERINE
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 309 COLUMBUS ST
Address2:  
City: RAPID CITY
State: SD
PostalCode: 577013716
CountryCode: US
TelephoneNumber: 3208283391
FaxNumber:  
Practice Location
Address1: 1420 N 10TH ST
Address2:  
City: SPEARFISH
State: SD
PostalCode: 577831532
CountryCode: US
TelephoneNumber: 6057178595
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/09/2022
LastUpdateDate: 02/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XCP002299SDY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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