Active NPI
Kadee Colleen Gullickson, PHARMD
- Pharmacist
- Park River, ND
National Provider Identifier
1801536289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH6379
- Practice address
- 503 Park St W
Park River, ND 58270-4137 - Phone
- (701) 284-7676
- NPI assigned
- Mar 31, 2022
- Last updated
- Mar 31, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH6379 | ND | Primary |
Addresses
Primary practice location
503 Park St W
Park River, ND 58270-4137
Mailing address
PO Box 111
Hoople, ND 58243-0111
Phone (701) 331-9243
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH6379 | ND | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648684800000",
"number": "1801536289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 111",
"city": "HOOPLE",
"state": "ND",
"postal_code": "582430111",
"telephone_number": "701-331-9243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 PARK ST W",
"city": "PARK RIVER",
"state": "ND",
"postal_code": "582704137",
"telephone_number": "701-284-7676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULLICKSON",
"first_name": "KADEE",
"middle_name": "COLLEEN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-31",
"last_updated": "2022-03-31",
"certification_date": "2022-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ND",
"license": "RPH6379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park River, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.