Most Relevant Information
Provider Data
| NPI Number: | 1003028598 |
| Provider Name: | RIKKI RAE FASTHORSE RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | R027379 |
Most Important Dates
| Enumeration Date: | 05/04/2007 |
| Last Updated: | 10/27/2009 |
Provider Practice Location
317 MAIN STREET
EAGLE BUTTE
SD
576251012
Practice Location Phone/Fax
| Phone: | 6059643007 |
| Fax: |
Provider Mailing Location
PO BOX 1802
EAGLE BUTTE
SD
576251802
Provider Mailing Phone/Fax
| Phone: | 6059643007 |
| Fax: |