Jerstad, Kelly Michele
Jerstad, Kelly Michele is an individual health care provider with primary practice located at 4950 S Minnesota Ave , Sioux Falls SD 57108-2864. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Jerstad, Kelly Michele can be contacted via phone (605) 330-9619.Contact Information
Primary practice address
4950 S Minnesota Ave
Sioux Falls SD 57108-2864
Phone: (605) 330-9619
Fax: (605) 330-9503
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 5248 | South Dakota |
Profile Details
| NPI number | 1417954470 |
|---|---|
| LBN Legal business name | Jerstad, Kelly Michele |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2005 |
| Last updated | Jun 17th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417954470 | NPPES |
| South Dakota | MEDICAID | 5900450 |
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