Provider Demographics
NPI:1942233432
Name:SIKKINK, KARI R N (MD)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:R N
Last Name:SIKKINK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 CURVE CREST BLVD W
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6040
Practice Address - Country:US
Practice Address - Phone:651-439-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33648207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12965Medicaid
ND37654OtherSIOUX VALLEY #
ND870277200Medicaid
ND28953OtherLHS #
ND6606472OtherMEDICA UC-INN #
ND74G11SIOtherMNBS FGO #
NDDA9011031056OtherPREF 1 #
NDHP40870OtherHEALTHPARTNERS #
ND762753OtherARAZ #
ND0116762OtherMEDICA FGO #
ND24079OtherNDBS #
ND137100OtherUCARE #
NDP00128374Medicare ID - Type UnspecifiedRAILROAD MEDICARE #
NDHP40870OtherHEALTHPARTNERS #
ND74G11SIOtherMNBS FGO #