Provider Demographics
NPI:1063516318
Name:KLEPETKA, NANCY ANN (DC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:KLEPETKA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 3RD AVE E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-1573
Mailing Address - Country:US
Mailing Address - Phone:320-762-2311
Mailing Address - Fax:320-762-8942
Practice Address - Street 1:418 3RD AVE E
Practice Address - Street 2:SUITE 101
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-1573
Practice Address - Country:US
Practice Address - Phone:320-762-2311
Practice Address - Fax:320-762-8942
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3473111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4485499OtherMEDICA
MN5C670KLOtherBCBS MN
MN5C670KLOtherBCBS MN