1669708129 NPI number — DIANE R SCHMIDT-KRINGS MD PC

Table of content: MS. KATHLEEN MICHELLE RULKA LMFT (NPI 1922217207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669708129 NPI number — DIANE R SCHMIDT-KRINGS MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIANE R SCHMIDT-KRINGS MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669708129
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3270 20TH ST S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARGO
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58104-5917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-296-7408
Provider Business Mailing Address Fax Number:
701-235-2099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3270 20TH ST S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARGO
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58104-5917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-296-7408
Provider Business Practice Location Address Fax Number:
701-235-2099
Provider Enumeration Date:
10/19/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
UNGER
Authorized Official First Name:
JEAN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
BUSINESS OFFICE MANAGER
Authorized Official Telephone Number:
701-499-4806

Provider Taxonomy Codes

  • Taxonomy code: 2086S0122X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)