| |
900 E Broadway Ave, Bismarck, ND 58501 | |
(701) 530-7000 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 900 E Broadway Ave, Bismarck, North Dakota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629121074 | NPI | - | NPPES |
1459154 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 5510, Bismarck, ND 58506-5510 Ph: (701) 530-7000 | 900 E Broadway Ave, Bismarck, ND 58501 Ph: (701) 530-7000 |