McKenzie Holty
Physician Assistant in Rapid City, SD. Individual provider (NPI-1).
NPI number1619704087
StatusActive
Last updated in NPPESSep 18, 2024
Details
- NPI
- 1619704087
- Entity type
- Individual (NPI-1)
- Name
- McKenzie Holty
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 18, 2024
- Certification date
- Sep 18, 2024
- Last updated
- Sep 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 1562 | SD | Yes |
Practice location
353 Fairmont BlvdRapid City, SD 57701-7375
Phone 605-755-4300
Mailing address
353 Fairmont BlvdRapid City, SD 57701-7375
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