Individual
KARA DENAE EICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 234-7400
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
11645
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15364
—
ND
05
—
1710160379
—
MN
Enumeration date
12/06/2007
Last updated
05/22/2023
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