Provider Demographics
NPI:1588661995
Name:UECKER-BEZDICEK, KAREN (F-CNP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:UECKER-BEZDICEK
Suffix:
Gender:F
Credentials:F-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:308 8TH ST N
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKE
Practice Address - State:MN
Practice Address - Zip Code:56159-1568
Practice Address - Country:US
Practice Address - Phone:507-427-3332
Practice Address - Fax:507-427-2493
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN145363L00000X
MNR119930-5363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN042740300Medicaid
SDP67838Medicare PIN
MN500002992Medicare PIN
MNP67838Medicare UPIN
MN500002993Medicare PIN
MN042740300Medicaid