Provider Demographics
NPI:1699032888
Name:STAUSS, JOEL D (CRNA)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:D
Last Name:STAUSS
Suffix:
Gender:M
Credentials:CRNA
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 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 S BYRON BLVD
Practice Address - Street 2:
Practice Address - City:CHAMBERLAIN
Practice Address - State:SD
Practice Address - Zip Code:57325-9741
Practice Address - Country:US
Practice Address - Phone:605-234-6551
Practice Address - Fax:605-322-2727
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCR000781367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1699032888Medicaid
MN1699032888Medicaid
SD1699032888Medicaid
NE46022474348Medicaid
1699032888OtherWELLMARK BCBS/TRICARE
1699032888OtherDAKOTACARE
1699032888OtherBCBS MN
1699032888OtherWELLMARK BCBS/TRICARE