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General NPI Number Information
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NPI Number | 1558029173
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Entity Type | Individual
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Provider Name | KENDALL DYKE CNP
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Gender | Female
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 105 S STATE ST STE 113
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City | ABERDEEN
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State | SD
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Zip | 57401-4502
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Country | US
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Telephone | 605-225-0378
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Fax | 605-225-7919
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Provider Business Mailing Address
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Address Line | 1015 7TH AVE SE APT 13
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City | ABERDEEN
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State | SD
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Zip | 57401-6330
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Country | US
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Telephone | 616-427-9627
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CP002224
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License Number State | SD
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