Healthcare Provider Details

I. General information

NPI: 1952234221
Provider Name (Legal Business Name): ASHLEY O'KONEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15681 50TH ST NE
SAINT MICHAEL MN
55376-3264
US

IV. Provider business mailing address

15681 50TH ST NE
SAINT MICHAEL MN
55376-3264
US

V. Phone/Fax

Practice location:
  • Phone: 320-266-1198
  • Fax:
Mailing address:
  • Phone: 320-266-1198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2321279
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: