NPI 1295069664 · live from the CMS NPI Registry
Megan Jean Boose, PA-C
Physician Assistant in Fargo, ND. National Provider Identifier 1295069664, active.
NPI record
| NPI | 1295069664 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 3173 43rd St S Ste A, Fargo, ND 58104 |
| Practice phone | 701-478-8780 |
| Enumerated | October 1, 2009 |
| Last updated | August 18, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 25MP00226200 (NJ) |
| Physician Assistant primary | 363A00000X | PAC0844 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.