Provider Demographics
NPI:1104871292
Name:ENGELMANN, TERRY (CNM)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:ENGELMANN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-7700
Mailing Address - Fax:605-328-7775
Practice Address - Street 1:1500 W 22ND ST
Practice Address - Street 2:STE 301
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-7702
Practice Address - Country:US
Practice Address - Phone:605-328-7700
Practice Address - Fax:605-328-7775
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCM000022363L00000X
MNR1436615367A00000X
SDR016975367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S89563Medicare UPIN
SDS100760Medicare PIN