Healthcare Provider Details

I. General information

NPI: 1871543967
Provider Name (Legal Business Name): DOROTHY JOY UNGER CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 9TH ST N
VIRGINIA MN
55792-2348
US

IV. Provider business mailing address

901 9TH ST N
VIRGINIA MN
55792-2348
US

V. Phone/Fax

Practice location:
  • Phone: 218-748-7480
  • Fax:
Mailing address:
  • Phone: 218-748-7480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR072343-6
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: