Individual
MRS. LACI ANN DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
615 WASHINGTON ST, PELLA, IA 50219-1538
(641) 628-2222
(641) 628-2915
Mailing address
1202 W HOWARD ST, KNOXVILLE, IA 50138-3103
(641) 842-2151
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A112498
IA
Other
Enumeration date
09/15/2014
Last updated
08/12/2020
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