Provider Demographics
NPI:1659584852
Name:DIEDE-KAY, VICKI S (RDMS)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:S
Last Name:DIEDE-KAY
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:ELK POINT
Mailing Address - State:SD
Mailing Address - Zip Code:57025-2265
Mailing Address - Country:US
Mailing Address - Phone:605-761-1811
Mailing Address - Fax:
Practice Address - Street 1:1808 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:ELK POINT
Practice Address - State:SD
Practice Address - Zip Code:57025-2265
Practice Address - Country:US
Practice Address - Phone:605-761-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other