NPI 1992406656 · live from the CMS NPI Registry
Sidney R Johnk, APRN,CNP
Nurse Practitioner, Pediatrics in Fargo, ND. National Provider Identifier 1992406656, active.
NPI record
| NPI | 1992406656 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 4110 51st Ave S, Fargo, ND 58104 |
| Practice phone | 701-364-3100 |
| Mailing address | 1702 University Dr S, Fargo, ND 58103 |
| Enumerated | March 10, 2023 |
| Last updated | March 10, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | R42226 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.