Individual provider · Type 1 NPI

Mary Fanta

Physician Assistant · Brookings, SD

NPI number 1508774126 Active

Practice location

400 22nd Ave
Brookings, SD 57006-2447

Call (605) 697-9500 Map

Mailing address

1602 1st St
Brookings, SD 57006-2617

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1508774126

Mary Fanta's National Provider Identifier is 1508774126, issued on Sep 1, 2026. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Brookings, SD. The record was last updated on Sep 1, 2026.