Andvik, Debra

Andvik, Debra is an individual health care provider with primary practice located at 3280 20Th St S , Fargo ND 58104-5917. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Andvik, Debra can be contacted via phone (701) 499-4800.

Contact Information

Primary practice address
3280 20Th St S Fargo ND 58104-5917
Phone: (701) 499-4800
Fax: (701) 451-9452
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PAC0194 North Dakota

Profile Details

NPI number 1821172404
LBN Legal business name Andvik, Debra
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Mar 4th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821172404 NPPES
Minnesota Other 212K9AN MNBS
Minnesota MEDICAID 048592600 MNBS
Minnesota MEDICAID 16541 MNBS
Minnesota Other P00189293 MNBS
Minnesota Other 024067 MNBS

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