Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 71009080A | IN |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SD-CNP CP000901 | SD |
NPI | 1508269432 |
---|---|
Provider Name | Angi Kiewel |
First Address | Rapid City, SD 57701-7375 |
Second Address | Evansville, IN 47710-1715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2014 |
Last Update Date | 11/07/2019 |