Individual provider · Type 1 NPI
Bailey B. Tetrault, CNP
Family Nurse Practitioner · Fort Meade, SD
NPI number
1639930902
Active
Practice location
113 Comanche Rd # R0AD
Fort Meade, SD 57741-1002
Mailing address
1906 Absaroka St
Spearfish, SD 57783-3313
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | CP003084 (SD) |
Family Nurse Practitioner: Definition to come...
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About NPI 1639930902
Bailey B. Tetrault, CNP's National Provider Identifier is 1639930902, issued on Jan 23, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Fort Meade, SD. The record was last updated on Jan 23, 2024.