Mylant, Marylou

Mylant, Marylou is an sole proprietor health care provider with primary practice located at 1011 11Th St , Rapid City SD 57701-3530. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Child & Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Mylant, Marylou can be contacted via phone (605) 394-6617.

Contact Information

Primary practice address
1011 11Th St Rapid City SD 57701-3530
Phone: (605) 394-6617
Fax: (605) 394-1250
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Child & Family 364SP0810X R025102 South Dakota
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R025102 South Dakota

Profile Details

NPI number 1700065208
LBN Legal business name Mylant, Marylou
Credentials PHD, RN, PMHNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2007
Last updated Oct 31st, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700065208 NPPES
South Dakota MEDICAID 6575492

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