| Prairie Family Healthcare, P.c. | |
|
1115 E 5th Ave Mitchell SD 57301-2917 | |
| (605) 996-5553 | |
| (605) 996-1213 |
| Full Name | Prairie Family Healthcare, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1115 E 5th Ave, Mitchell, South Dakota |
| Authorized Official Name and Position | Diane Lynn Kenkel (PRESIDENT) |
| Authorized Official Contact | 6059965553 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Family Healthcare, P.c. 1115 E 5th Ave Mitchell SD 57301-2917 Ph: (605) 996-5553 | Prairie Family Healthcare, P.c. 1115 E 5th Ave Mitchell SD 57301-2917 Ph: (605) 996-5553 |
| NPI Number | 1962648287 |
|---|---|
| Provider Enumeration Date | 12/17/2008 |
| Last Update Date | 12/17/2008 |
| Medicare PECOS PAC ID | 1951464429 |
|---|---|
| Medicare Enrollment ID | O20090109000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962648287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CP000190 (South Dakota) | Primary |
| Provider Name | Diane L Kenkel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588662688 PECOS PAC ID: 1557353000 Enrollment ID: I20040402000393 |
| Provider Name | Kristin J Bietz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144714205 PECOS PAC ID: 3274880042 Enrollment ID: I20180725000988 |
| Provider Name | Alahna E Gross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366720864 PECOS PAC ID: 4183899172 Enrollment ID: I20210325001073 |
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