Individual
VICKI HACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
420 SOUTH 7TH STREET, OAKES, ND 58474-2024
(701) 742-3267
(701) 742-3201
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(701) 234-2119
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0233
ND
363AM0700X
Medical Physician Assistant
PAC0233
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18953
BLUE SHIELD
ND
01
—
18954
BLUE SHIELD
ND
01
—
18955
BLUE SHIELD
ND
01
—
25995
BLUE SHIELD
ND
01
—
28594
BLUE SHIELD
ND
01
—
28595
BLUE SHIELD
ND
01
—
28596
BLUE SHIELD
ND
05
—
71051
—
ND
01
—
970013748
RAILROAD MEDICARE
ND
01
—
CF8850
RAILROAD MEDICARE
ND
Enumeration date
10/19/2005
Last updated
07/24/2024
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