Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | CP000604 | SD |
NPI | 1033423322 |
---|---|
Provider Name | Rachael R Dekker |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Worthington, MN 56187 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2010 |
Last Update Date | 11/12/2020 |