NPI 1487715405 · live from the CMS NPI Registry
Nancy M Eastman, PA-C
Physician Assistant in Fargo, ND. National Provider Identifier 1487715405, active.
NPI record
| NPI | 1487715405 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 4622 40th Ave S, Fargo, ND 58104 |
| Practice phone | 701-364-2909 |
| Mailing address | 820 4th St N, Fargo, ND 58102 |
| Enumerated | December 13, 2006 |
| Last updated | January 8, 2011 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 9637 (MN) |
| Physician Assistant | 363A00000X | PAC0342 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.