Doctor Name: | KATHLEEN LEE SIEDSCHLAG |
NPI Number: | 1992925499 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PAC0176 |
Business Practice Address: | 420 S 7th St Oakes, ND - 584742024 |
Business Phone Number: | 7017423267 |
Business Fax Number: | 7017423201 |
Mailing Address: | Po Box 50, OAKES |
State: | ND |
Postal Code: | 584740050 |
Phone Number: | 7017423267 |
Fax Number: | 7017423201 |
NPI Enumeration Date: | 04/26/2007 |
NPI Last Update Date: | 03/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PAC0176 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |