Pantzke, Traci Lynn

Pantzke, Traci Lynn is an individual health care provider with primary practice located at 2301 25Th St S Ste K, Fargo ND 58103-6104. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Pantzke, Traci Lynn can be contacted via phone (701) 234-1728.

Contact Information

Primary practice address
2301 25Th St S Ste K Fargo ND 58103-6104
Phone: (701) 234-1728
Fax: (701) 234-1628
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R22825 North Dakota

Profile Details

NPI number 1932159183
LBN Legal business name Pantzke, Traci Lynn
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Nov 15th, 2007 - about 18 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 1932159183 NPPES
North Dakota Other 020823 ND BLUE SHIELD
North Dakota Other 131R8PA ND BLUE SHIELD
North Dakota MEDICAID 10221 ND BLUE SHIELD

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