Healthcare Provider Details

I. General information

NPI: 1689352056
Provider Name (Legal Business Name): ANDREA OKERSTROM PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 W LINCOLN AVE STE 104
FERGUS FALLS MN
56537-2146
US

IV. Provider business mailing address

225 W LINCOLN AVE STE 104
FERGUS FALLS MN
56537-2146
US

V. Phone/Fax

Practice location:
  • Phone: 218-531-1424
  • Fax: 218-531-1420
Mailing address:
  • Phone: 218-531-1424
  • Fax: 218-531-1420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR52700
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10391
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: