Provider Demographics
NPI:1336450543
Name:KLEMME, REBEKKA (CNP)
Entity Type:Individual
Prefix:
First Name:REBEKKA
Middle Name:
Last Name:KLEMME
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 1:2400 S. MINNESOTA AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-3762
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1315 S. CLIFF AVE.
Practice Address - Street 2:STE. 1100
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1057
Practice Address - Country:US
Practice Address - Phone:605-322-7350
Practice Address - Fax:605-322-7351
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000616363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6833363Medicaid
SD6833362Medicaid
SD6833360Medicaid
SD6833363Medicaid
SDS105088Medicare PIN
SDS107724Medicare PIN