Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | CP001853 | SD |
N | 363LF0000X | Nurse Practitioner - Family Medicine | CP001853 | SD |
NPI | 1003413683 |
---|---|
Provider Name | Mariah Schurman |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Sioux Falls, SD 57105-0401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2020 |
Last Update Date | 21/12/2020 |