Provider Demographics
NPI:1992751267
Name:FREE, NANCY M (DO)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:FREE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4405 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-4136
Mailing Address - Country:US
Mailing Address - Phone:605-328-9080
Mailing Address - Fax:605-328-9081
Practice Address - Street 1:1305 W 18TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0401
Practice Address - Country:US
Practice Address - Phone:605-333-2226
Practice Address - Fax:605-333-2222
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD3504208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD370019785Medicare PIN
F21042Medicare UPIN
SDS8255Medicare PIN