Healthcare Provider Details
I. General information
NPI: 1528747763
Provider Name (Legal Business Name): KARI ANN KUDRNA DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/14/2023
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 FAIRWAY ST
DICKINSON ND
58601-2639
US
IV. Provider business mailing address
2500 FAIRWAY ST
DICKINSON ND
58601-2639
US
V. Phone/Fax
- Phone: 701-456-4000
- Fax:
- Phone: 701-325-0127
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | R46041 |
| License Number State | ND |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: