Provider Demographics
NPI:1194807511
Name:RHEAULT, LINDSAY MARIE (CNP)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:RHEAULT
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 1:45434 222ND ST
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:SD
Mailing Address - Zip Code:57054-6108
Mailing Address - Country:US
Mailing Address - Phone:605-366-0041
Mailing Address - Fax:
Practice Address - Street 1:WELLNESS CTR
Practice Address - Street 2:BOX 2818
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57007-0001
Practice Address - Country:US
Practice Address - Phone:605-688-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000480363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily