Healthcare Provider Details

I. General information

NPI: 1700307170
Provider Name (Legal Business Name): KARI LYNN HEKTNER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 02/14/2021
Certification Date: 02/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 BROADWAY N
FARGO ND
58102
US

IV. Provider business mailing address

711 SOUTHWOOD DR S
FARGO ND
58103-6017
US

V. Phone/Fax

Practice location:
  • Phone: 701-234-2525
  • Fax: 701-234-2910
Mailing address:
  • Phone: 701-793-4556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR34341
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR34341
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: