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Individual

KIMBERLY DYKSTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1000 LINCOLN CIR SE, ORANGE CITY, IA 51041-1836
(712) 737-2000
Mailing address
1000 LINCOLN CIR SE, ORANGE CITY, IA 51041-1836
(712) 737-2000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0682
SD
363A00000X
Physician Assistant
Primary
078081
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
078081
LICENSE
IA
Enumeration date
08/01/2008
Last updated
02/09/2023
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