Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 7382 | MN |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | A163231 | IA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | CP001562 | SD |
NPI | 1033548854 |
---|---|
Provider Name | Mr. Wade Robert Sendelbach |
First Address | Sioux Falls, SD 57104-7111 |
Second Address | Sioux Falls, SD 57105-1007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2013 |
Last Update Date | 28/04/2021 |