MRS. DEBRA ANDVIK (NPI# 1821172404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821172404 |
| Entity Type | Individual |
| Full Name | MRS. DEBRA ANDVIK |
| Credential | PAC |
| Practice Address |
3280 20th St S Fargo ND 58104-5917 |
| Practice Telephone | 7014994800 |
| Practice Fax Number | 7014519452 |
| Mailing Telephone | 7014994800 |
| Mailing Fax Number | 7014519452 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2009-03-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PAC0194 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | NDBS | 024067 | 01 |
| ND | RAILROAD MEDICARE | P00189293 | 01 |
| ND | 16541 | 05 | |
| MN | 048592600 | 05 | |
| MN | MNBS | 212K9AN | 01 |
| Street Address |
3280 20TH ST S |
| City | FARGO |
| State | ND |
| Zip Code | 58104-5917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457353690 | Ahmed Abdullah | Plastic Surgery | 3280 20th St S, Fargo, ND 58104-5917 | 2005-06-01 |
| 1710238233 | Fargo Plastic Surgery PC | Clinic/Center | 3280 20th St S, Fargo, ND 58104-5917 | 2012-09-24 |
| 1659620110 | Fargo Plastic Surgery PC | Plastic Surgery | 3280 20th St S, Fargo, ND 58104-5917 | 2012-08-30 |
| 1184905309 | Abdullah Surgical Center LLC | Clinic/Center | 3280 20th St S, Fargo, ND 58104-5917 | 2011-09-01 |
| 1033386859 | Heartland Diagnostic Services LLC | Radiologic Technologist | 3280 20th St S, Fargo, ND 58104-5917 | 2008-05-12 |
| 1679605513 | Anesthesia Resources | Nurse Anesthetist, Certified Registered | 3280 20th St S, Fargo, ND 58104-5917 | 2007-03-09 |
| 1841357399 | Charles I Benjamin Md PC | Plastic Surgery | 3280 20th St S, Fargo, ND 58104-5917 | 2007-01-03 |
| 1033276415 | David M Beard Md PC | Orthopaedic Surgery | 3280 20th St S, Fargo, ND 58104-5917 | 2007-01-03 |
| 1376613521 | Jon Norberg Md PC | Orthopaedic Surgery | 3280 20th St S, Fargo, ND 58104-5917 | 2006-11-08 |
| 1477638864 | Plastic Surgery Institute, PC | Surgery | 3280 20th St S, Fargo, ND 58104-5917 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205015633 | Jamie M Brown | Physician Assistant | 1711 Gold Dr S, Suite 170, Fargo, ND 58103-6416 | 2007-11-02 |
| 1790703353 | Mary Jane Kadry | Physician Assistant | 1121 Westrac Dr S Ste 204, Fargo, ND 58103-2385 | 2006-07-18 |
| 1861419723 | Catherine M Garvey | Physician Assistant | 2801 University Dr S, Fargo, ND 58103-6029 | 2006-07-16 |
| 1881148005 | Kali Luecke | Physician Assistant | 301 Np Ave N, Fargo, ND 58102-4835 | 2016-08-04 |
| 1215480009 | Jason Byrne Smith | Physician Assistant | 801 Broadway N, Fargo, ND 58102-3641 | 2016-07-27 |
| 1659758381 | Sarah Winter | Physician Assistant | 1702 University Dr S, Fargo, ND 58103-4940 | 2015-05-01 |
| 1861801763 | Lisa Lynn Froemke | Physician Assistant | 3838 12th Ave N, Fargo, ND 58102-2931 | 2014-08-05 |
| 1033525365 | Kathryn Gray | Physician Assistant | 301 Np Ave N, Fargo, ND 58102-4835 | 2014-07-08 |
| 1326462490 | Shannon Lynn Gullingsrud | Physician Assistant | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2014-02-10 |
| 1467722702 | Yan Tesch | Physician Assistant | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2012-01-04 |
| Find all providers in FARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.