NPI 1710668595 · live from the CMS NPI Registry
Ashley Black, PA-C
Physician Assistant in Grand Forks, ND. National Provider Identifier 1710668595, active.
NPI record
| NPI | 1710668595 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 4440 S. Washington St., Grand Forks, ND 58201 |
| Practice phone | 701-732-7600 |
| Mailing address | 2401 Demers Ave, Grand Forks, ND 58201 |
| Enumerated | July 26, 2023 |
| Last updated | July 26, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | PAC1017 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.