Individual
KATHLEEN LEE SIEDSCHLAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
420 S 7TH ST, OAKES, ND 58474-2024
(701) 742-3267
(701) 742-3201
Mailing address
PO BOX 50, OAKES, ND 58474-0050
(701) 742-3267
(701) 742-3201
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0176
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71192
—
ND
05
—
71277
—
ND
01
—
970009837
TRAVELERS MEDICARE
ND
01
—
CF8850
TRAVELERS MEDICARE
ND
Enumeration date
04/26/2007
Last updated
03/06/2013
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