NPI 1033813555 · live from the CMS NPI Registry
Nicholas Joseph Fenske, PA-C
Physician Assistant in Baxter, MN. National Provider Identifier 1033813555, active.
NPI record
| NPI | 1033813555 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 13060 Isle Dr, Baxter, MN 56425 |
| Practice phone | 218-828-2880 |
| Mailing address | 1702 University Dr S, Fargo, ND 58103 |
| Enumerated | March 28, 2023 |
| Last updated | November 12, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 15110 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.