Individual
PEGGY J DYKEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN CRNP
Contact information
Practice address
5234 LAWLER BEACH RD, WILLMAR, MN 56201-9120
(320) 231-5000
(320) 231-5067
Mailing address
2420 W DIVISION ST, SAINT CLOUD, MN 56301-3926
(320) 231-5000
(320) 231-5067
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0753810
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
595716100
—
MN
Enumeration date
03/03/2006
Last updated
05/18/2016
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