KRYSTAL NIESEN (NPI# 1639610116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639610116 |
| Entity Type | Individual |
| Full Name | KRYSTAL NIESEN |
| Credential | PA-C |
| Practice Address |
1210 W 18th St Suite G01 Sioux Falls SD 57104-4647 |
| Practice Telephone | 6053282663 |
| Mailing Telephone | 6053282663 |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1078 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1210 W 18TH ST SUITE G01 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57104-4647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043216955 | John Elmer Forrette Jr. | Podiatrist | 1210 W 18th St, Sioux Falls, SD 57104-4647 | 2005-06-24 |
| 1437701570 | April E Labat | Nurse Practitioner | 1210 W 18th St, Sioux Falls, SD 57104-4647 | 2019-07-09 |
| 1245731728 | Jonathan Sorensen | Nurse Practitioner | 1210 W 18th St, Sioux Falls, SD 57104-4647 | 2018-02-21 |
| 1811433709 | Marie Hansen | Physician Assistant | 1210 W 18th St, Suite G01, Sioux Falls, SD 57104-4647 | 2017-01-16 |
| 1952843054 | Megan Marie Weston | Nurse Practitioner | 1210 W 18th St, Suite 100, Sioux Falls, SD 57104-4647 | 2016-11-07 |
| 1497203780 | Stacy Eden | Nurse Practitioner | 1210 W 18th St, Sioux Falls, SD 57104-4647 | 2016-09-14 |
| 1689021537 | Christopher De Berg | Nurse Practitioner | 1210 W 18th St, Suite G01, Sioux Falls, SD 57104-4651 | 2016-05-20 |
| 1902285463 | Caleb Richard Blauwet | Physician Assistant | 1210 W 18th St, Suite G01, Sioux Falls, SD 57104-4647 | 2015-05-29 |
| 1144613803 | Joanne Gunderson | Nurse Practitioner | 1210 W 18th St, Ste 100, Sioux Falls, SD 57104-9890 | 2015-03-05 |
| 1538576871 | Justin David Tuntland | Nurse Practitioner | 1210 W 18th St, Ste 100, Sioux Falls, SD 57104-9890 | 2014-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518594134 | Melissa Bader | Nurse Practitioner | 1112 S. Lake Ave, Suite 201, Sioux Falls, SD 57104 | 2020-03-24 |
| 1457995714 | Sanford Clinic | Clinic/Center | 1112 S Lake Ave, Ste 201, Sioux Falls, SD 57104 | 2019-10-30 |
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1033637210 | Anna Peasley | Speech-Language Pathologist | 710 W 18th St, Sioux Falls, SD 57104 | 2017-09-07 |
| 1699204313 | Sioux Falls Primary Home Care Services LLC | In Home Supportive Care | 201 N Minnesota Ave Ste 101l, Sioux Falls, SD 57104 | 2017-06-06 |
| 1093258808 | Megan Regina Wexler | Social Worker | 4510 N Lewis Ave, Sioux Falls, SD 57104 | 2016-11-28 |
| 1831645498 | Ryan Ortiz | Specialist/Technologist | 1908 1/2 Old Town Rd Nw, Albuquerque, NM 57104 | 2016-09-01 |
| 1881140622 | Kristine Carol Smith | Occupational Therapist | 601 N. Spring Ave, Hawthorne Elementary, Sioux Falls, SD 57104 | 2016-08-31 |
| 1215299292 | Jolene Mitchell | Preventive Medicine | 900 E 54th St N Ste 100, Sioux Falls, SD 57104 | 2012-06-14 |
| 1871874651 | Christine Marie Burg | Pharmacist | 2503 East 54th Street N., Medvantx Pharmacy Services, Sioux Falls, SD 57104 | 2011-09-07 |
| Find all providers in zip 57104 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627898 | Mikaela Theobald | Physician Assistant | 6101 E Quartzite Dr, Sioux Falls, SD 57110-3988 | 2020-10-22 |
| 1467064097 | Kara Rae Koth | Physician Assistant | 4913 E 42nd St, Sioux Falls, SD 57110-4409 | 2020-08-17 |
| 1528695798 | Allison Mcentee | Physician Assistant | 3620 East Prairiewind Street, Sioux Falls, SD 57108 | 2020-03-26 |
| 1326608910 | Ashley Pommer | Physician Assistant | 8232 W 51st St, Sioux Falls, SD 57106-7861 | 2019-06-17 |
| 1225550908 | Almir Krdzalic | Physician Assistant | 110 W Honors St, Sioux Falls, SD 57108-8174 | 2017-07-13 |
| 1598160335 | Heidi Jo Vogel | Physician Assistant | 1417 S Cliff Avenue, Suite 200, Sioux Falls, SD 57105 | 2014-10-22 |
| 1639507882 | Kelsey Isaacson | Physician Assistant | 4201 S Minnesota Ave, Suite 112, Sioux Falls, SD 57105-6705 | 2013-10-25 |
| 1033551114 | Karissa G Zimmer | Physician Assistant | 2315 W. 57th Street, Suite 300, Sioux Falls, SD 57108 | 2013-07-18 |
| 1740623065 | Nicolette Schmuck | Physician Assistant | 1500 W 22nd St Ste 302, Sioux Falls, SD 57105-1599 | 2013-04-17 |
| 1023389392 | Leah Ayn Mergen | Physician Assistant | 521 N Main Ave Ste 100, Sioux Falls, SD 57104-5947 | 2012-01-19 |
| Find all providers in SIOUX FALLS | ||||
| City | SIOUX FALLS |
| Zip Code | 57104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.