Provider Information for 1407497845
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STACY LYNN HERMAN
Sex: Female
NPI: 1407497845
Last Updated: 2023-07-13
Certification Date: 2023-07-13
Certification Date: 2023-07-13
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1407497845 | ||||||||||||
| Enumeration Date | 2019-10-07 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 910 S CHICAGO ST HOT SPRINGS, SD 57747-2836 United States Phone: 605-891-4184 | Fax: | ||||||||||||
| Primary Practice Address | 910 S CHICAGO ST HOT SPRINGS, SD 57747-2836 United States Phone: 605-891-4184 | Fax: | ||||||||||||
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