Provider Demographics
NPI:1992006282
Name:SCHREMPP, SERRA K (RN)
Entity Type:Individual
Prefix:
First Name:SERRA
Middle Name:K
Last Name:SCHREMPP
Suffix:
Gender:F
Credentials:RN
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 6000
Mailing Address - Street 2:RHP
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57709-6000
Mailing Address - Country:US
Mailing Address - Phone:605-755-9052
Mailing Address - Fax:
Practice Address - Street 1:4940 5TH ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-6025
Practice Address - Country:US
Practice Address - Phone:605-716-8039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR034674163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0140070Medicaid
SD5549050Medicaid
SDPHS000Medicare UPIN
SD430082Medicare Oscar/Certification
SD0140070Medicaid