Provider Demographics
NPI:1174711840
Name:KUIPER, GARNETH (CNP)
Entity type:Individual
Prefix:
First Name:GARNETH
Middle Name:
Last Name:KUIPER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:GARNETH
Other - Middle Name:E
Other - Last Name:ALTENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 86370
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57118-6370
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:4400 W 69TH ST
Practice Address - Street 2:STE. 1500
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8170
Practice Address - Country:US
Practice Address - Phone:605-322-5700
Practice Address - Fax:605-322-5704
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDTEMPORARY - CNP APP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD254873OtherMIDLANDS CHOICE
SD370624200OtherDEPT OF LABOR
SD57108C038OtherWPS TRICARE
MN37L31KUOtherCC SYSTEMS/ BLUE PLUS
SD412991053244OtherPREFERRED ONE
SD9253810OtherDAKOTACARE
MN106687000Medicaid
SD1174711840OtherARAZ/ AMERICA'S PPO
SD4992660OtherBLUE CROSS
MN040121002OtherPRIMEWEST
ND12200Medicaid
NE46022474352Medicaid
IA3148379Medicaid
SDHP85930OtherHEALTHPARTNERS
MN37L31KUOtherCC SYSTEMS/ BLUE PLUS