Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 12856 | SD |
NPI | 1003304486 |
---|---|
Provider Name | Bethany Kay Zeigler |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Sioux Falls, SD 57103-4187 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2018 |
Last Update Date | 01/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003304486 | (05) | IN |
1003304486 | MEDICARE-OPR (01) | IN |