Provider Demographics
NPI:1427463371
Name:EDMAN, ELIZABETH CECILIA (CNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CECILIA
Last Name:EDMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:CECILIA
Other - Last Name:STAUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:1301 S. CLIFF AVE.
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1005
Mailing Address - Country:US
Mailing Address - Phone:605-322-5750
Mailing Address - Fax:605-322-5799
Practice Address - Street 1:1301 S. CLIFF AVE.
Practice Address - Street 2:SUITE 400
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1005
Practice Address - Country:US
Practice Address - Phone:605-322-5750
Practice Address - Fax:605-322-5799
Is Sole Proprietor?:No
Enumeration Date:2014-06-29
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000862363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care