Provider Demographics
NPI:1083167050
Name:TERVEER, JACQUE ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:JACQUE
Middle Name:ANN
Last Name:TERVEER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S SPLITROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:SD
Mailing Address - Zip Code:57005-1652
Mailing Address - Country:US
Mailing Address - Phone:605-582-3446
Mailing Address - Fax:605-582-3229
Practice Address - Street 1:7700 E WILLOWWOOD ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-7619
Practice Address - Country:US
Practice Address - Phone:605-582-1500
Practice Address - Fax:605-332-0947
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR033179163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool