Provider Demographics
NPI:1790941748
Name:JUHNKE, PATTY ANN (MSW)
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:ANN
Last Name:JUHNKE
Suffix:
Gender:F
Credentials:MSW
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. BYRON BLVD.
Mailing Address - Street 2:SANFORD MID-DAKOTA MEDICAL CENTER
Mailing Address - City:CHAMBERLAIN
Mailing Address - State:SD
Mailing Address - Zip Code:57325-9741
Mailing Address - Country:US
Mailing Address - Phone:605-234-7124
Mailing Address - Fax:605-234-7113
Practice Address - Street 1:300 S. BYRON BLVD.
Practice Address - Street 2:SANFORD MID-DAKOTA MEDICAL CENTER
Practice Address - City:CHAMBERLAIN
Practice Address - State:SD
Practice Address - Zip Code:57325-9741
Practice Address - Country:US
Practice Address - Phone:605-234-7124
Practice Address - Fax:605-234-7113
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD23271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical