Individual
DR. DAVINA KAY AIKO DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 45TH ST S, FARGO, ND 58103-1189
(701) 239-3700
Mailing address
1914 13TH AVE N, MOORHEAD, MN 56560-1820
(701) 239-3700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001312271
VA
Other
Enumeration date
10/02/2025
Last updated
10/02/2025
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