Provider Demographics
NPI:1962496752
Name:HOITEN, ROSE MARIE (CNM,CNP,IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:ROSE MARIE
Middle Name:
Last Name:HOITEN
Suffix:
Gender:F
Credentials:CNM,CNP,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44674 256TH ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:SD
Mailing Address - Zip Code:57048-6002
Mailing Address - Country:US
Mailing Address - Phone:605-769-0807
Mailing Address - Fax:605-363-3211
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:
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-116582363LF0000X
AK1040363LF0000X
SDCP000449 FAMILY363LF0000X
SDCM000046367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK0361450001Medicare NSC