Individual
KATIE MARIE RODACKER-BARTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1240 25TH ST S, FARGO, ND 58103-2367
(701) 271-2937
Mailing address
1240 25TH ST S, FARGO, ND 58103-2367
(701) 271-2937
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L13422
ND
Other
Enumeration date
11/03/2017
Last updated
03/02/2021
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