Provider Demographics
NPI:1932105590
Name:FOSS, NANCY K (CNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:K
Last Name:FOSS
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 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:605-328-7180
Mailing Address - Fax:605-328-7177
Practice Address - Street 1:1205 S GRANGE AVE
Practice Address - Street 2:STE 407
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0410
Practice Address - Country:US
Practice Address - Phone:605-328-8900
Practice Address - Fax:605-328-8901
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD0157363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6822772Medicaid
R02621Medicare UPIN
SD6822772Medicaid
SDS8313Medicare PIN