Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | CP002231 | SD |
NPI | 1235897620 |
---|---|
Provider Name | Erica Lauren Galbreath |
First Address | Rapid City, SD 57701-7375 |
Second Address | Rapid City, SD 57701-7375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2021 |
Last Update Date | 02/12/2021 |