Individual
KALI LUECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 NP AVE N, FARGO, ND 58102-4835
(701) 271-3344
(701) 271-1480
Mailing address
301 NP AVE N, FARGO, ND 58102-4835
(701) 271-3344
(701) 271-1480
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
085.005909
IL
363AM0700X
Medical Physician Assistant
Primary
PAC0748
ND
Other
Enumeration date
08/04/2016
Last updated
01/21/2019
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