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General NPI Number Information
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NPI Number | 1033423322
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Entity Type | Individual
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Provider Name | RACHAEL R DEKKER CNP, CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 1018 6TH AVE
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City | WORTHINGTON
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State | MN
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Zip | 56187
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Country | US
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Telephone | 605-321-3069
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5074
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City | SIOUX FALLS
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State | SD
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Zip | 57117-5074
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | CP000604
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CR000907
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License Number State | SD
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1941
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License Number State | MN
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