Healthcare Provider Details

I. General information

NPI: 1508979253
Provider Name (Legal Business Name): NEW DAY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 88TH AVE. WEST SUITE 2
DULUTH MN
55808
US

IV. Provider business mailing address

3920 13TH AVE E SUITE 6
HIBBING MN
55746-3675
US

V. Phone/Fax

Practice location:
  • Phone: 218-626-1222
  • Fax:
Mailing address:
  • Phone: 218-263-7540
  • Fax: 866-732-0699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number077946-7
License Number StateMN

VIII. Authorized Official

Name: PAM IDZIOREK
Title or Position: OWNER
Credential: RNNP
Phone: 218-626-1222