Provider Demographics
NPI:1396451555
Name:FELTMAN, LACEE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LACEE
Middle Name:
Last Name:FELTMAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HIDEAWAY DR
Mailing Address - Street 2:
Mailing Address - City:MISSION HILL
Mailing Address - State:SD
Mailing Address - Zip Code:57046-6014
Mailing Address - Country:US
Mailing Address - Phone:605-659-5262
Mailing Address - Fax:
Practice Address - Street 1:4308 S ARWAY DR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3131
Practice Address - Country:US
Practice Address - Phone:605-573-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP002672363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health