Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | CP000729 | SD |
NPI | 1285978916 |
---|---|
Provider Name | Jill M Barch |
First Address | Sioux Falls, SD 57117-5045 |
Second Address | Sioux Falls, SD 57105-1007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2012 |
Last Update Date | 19/11/2012 |