| Doctor Name: | MR. DALE KEN FITZKE |
| NPI Number: | 1225158488 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | R29497 |
| Business Practice Address: | 3883 74th Ave Ne Fort Totten, ND - 58335 |
| Business Phone Number: | 7017661600 |
| Business Fax Number: | 7017661626 |
| Mailing Address: | 132 14th Ave Ne, DEVILS LAKE |
| State: | ND |
| Postal Code: | 583013301 |
| Phone Number: | 7016624566 |
| Fax Number: | 7017661626 |
| NPI Enumeration Date: | 03/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | R29497 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |