NPI 1912200585 · live from the CMS NPI Registry
Donna Ellenson, PA
Physician Assistant, Medical in Fargo, ND. National Provider Identifier 1912200585, active.
NPI record
| NPI | 1912200585 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 737 Broadway N, Fargo, ND 58102 |
| Practice phone | 701-234-2251 |
| Mailing address | Po Box 2010, Fargo, ND 58122 |
| Enumerated | December 21, 2010 |
| Last updated | December 21, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | PAC0198 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.