Provider Demographics
NPI:1235489923
Name:KRICK, DEANNA JUNE (R N)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:JUNE
Last Name:KRICK
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 OAK ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4460
Mailing Address - Country:US
Mailing Address - Phone:701-746-5359
Mailing Address - Fax:
Practice Address - Street 1:718 OAK ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4460
Practice Address - Country:US
Practice Address - Phone:701-746-5359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND11396163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse