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General NPI Number Information
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NPI Number | 1952244824
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Entity Type | Individual
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Provider Name | KATERI VANRADEN
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Gender |
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 28331 S BUFFALO LAKE RD
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City | DETROIT LAKES
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State | MN
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Zip | 56501-7716
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Country | US
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Telephone | 701-305-0494
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Fax |
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Provider Business Mailing Address
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Address Line | 28331 S BUFFALO LAKE RD
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City | DETROIT LAKES
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State | MN
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Zip | 56501-7716
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 203422
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License Number State | ND
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