Provider Demographics
NPI:1447448287
Name:ONDIEKI, RITA KATHLYN
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:KATHLYN
Last Name:ONDIEKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12972 RADISSON RD NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449
Mailing Address - Country:US
Mailing Address - Phone:763-744-7237
Mailing Address - Fax:763-862-7438
Practice Address - Street 1:12972 RADISSON RD NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4931
Practice Address - Country:US
Practice Address - Phone:763-744-7237
Practice Address - Fax:763-862-7438
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-134369-8163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse