Provider Demographics
NPI:1679793988
Name:VEIT, LISA M (RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:VEIT
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:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:DUPREE
Mailing Address - State:SD
Mailing Address - Zip Code:57623-0308
Mailing Address - Country:US
Mailing Address - Phone:605-365-5221
Mailing Address - Fax:
Practice Address - Street 1:317 MAIN STREET
Practice Address - Street 2:
Practice Address - City:EAGLE BUTTE
Practice Address - State:SD
Practice Address - Zip Code:57625
Practice Address - Country:US
Practice Address - Phone:605-964-3004
Practice Address - Fax:605-964-1110
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR025696163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care