Individual
REBECCA ANN KIECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1720 SOUTH UNIVERSITY DRIVE, SANFORD SOUTH UNIVERSITY, FARGO, ND 58103
(701) 234-2000
(605) 622-2745
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-8311
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
CP000658
SD
363L00000X
Nurse Practitioner
Primary
R29811
ND
Other
Enumeration date
08/05/2011
Last updated
09/16/2020
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