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1639930902
BAILEY B TETRAULT
FORT MEADE, SD
NPI
1639930902
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SD CP003084)
Enumeration Date
2024-01-23
Last Update Date
2024-01-23
Business Address
Mrs. BAILEY B TETRAULT CNP
113 COMANCHE RD # R0AD
FORT MEADE, SD 57741-1002
Phone number: 605-347-2511
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Mailing Address
Mrs. BAILEY B TETRAULT CNP
1906 ABSAROKA ST
SPEARFISH, SD 57783-3313
Phone number: 605-478-0074
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