Provider Demographics
NPI:1881795946
Name:PUDENZ, LINDA MAE (CNS, RN)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MAE
Last Name:PUDENZ
Suffix:
Gender:F
Credentials:CNS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:810 E 23RD ST
Mailing Address - Street 2:PO BOX 5116
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2135
Mailing Address - Country:US
Mailing Address - Phone:605-331-5890
Mailing Address - Fax:605-336-3974
Practice Address - Street 1:810 E 23RD ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2135
Practice Address - Country:US
Practice Address - Phone:605-331-5890
Practice Address - Fax:605-336-3974
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SDR021526163WX0800X
SDCS004102364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
Not Answered364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist