Provider Demographics
NPI:1700858263
Name:KREIN, JULIE A (CNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:KREIN
Suffix:
Gender:F
Credentials:CNP
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 6540
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57709-6540
Mailing Address - Country:US
Mailing Address - Phone:605-341-5565
Mailing Address - Fax:605-341-5595
Practice Address - Street 1:7236 JORDAN DR STE 101
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-8740
Practice Address - Country:US
Practice Address - Phone:605-341-5565
Practice Address - Fax:605-341-5595
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY312320OtherWY BCBS NUMBER
SD4995966OtherWELLMARK BCBS NUMBER
SD6825190Medicaid
SD41491Medicare ID - Type UnspecifiedSD MEDICARE NUMBER
SDP99282Medicare UPIN
WY9812Medicare ID - Type UnspecifiedWY MEDICARE NUMBER
SD6825190Medicaid