Provider Demographics
NPI:1265760102
Name:MCDUGLE, REBECCA ANN (CNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:MCDUGLE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:911 E. 20TH ST.
Mailing Address - Street 2:STE. 700
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1049
Mailing Address - Country:US
Mailing Address - Phone:605-334-0393
Mailing Address - Fax:605-334-6028
Practice Address - Street 1:916 4TH AVE SW
Practice Address - Street 2:
Practice Address - City:PIPESTONE
Practice Address - State:MN
Practice Address - Zip Code:56164-1890
Practice Address - Country:US
Practice Address - Phone:605-334-0393
Practice Address - Fax:605-334-6028
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCS004119364SC0200X
SDR032447163W00000X
SDCP000582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse