Healthcare Provider Details

I. General information

NPI: 1861534919
Provider Name (Legal Business Name): KAREN M LIEPKE RN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 01/04/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 11TH ST W
WILLISTON ND
58801-4500
US

IV. Provider business mailing address

PO BOX 504
SIOUX FALLS SD
57101-0504
US

V. Phone/Fax

Practice location:
  • Phone: 701-774-7687
  • Fax:
Mailing address:
  • Phone: 605-328-9419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberR17752
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: