Provider Demographics
NPI:1366610032
Name:DICE, CATHERINE J (RN,CCT,RDCS,RCS,LPN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:J
Last Name:DICE
Suffix:
Gender:F
Credentials:RN,CCT,RDCS,RCS,LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 S MARION RD
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-3643
Mailing Address - Country:US
Mailing Address - Phone:605-215-8225
Mailing Address - Fax:605-215-8225
Practice Address - Street 1:1716 S MARION RD
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3643
Practice Address - Country:US
Practice Address - Phone:605-543-5026
Practice Address - Fax:605-543-5068
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD246X00000X
246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist Cardiovascular
No246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7290070Medicaid
SD0002272OtherSOUTH DAKOTA BLUE SHIELD
SD0002272OtherSOUTH DAKOTA BLUE SHIELD