Healthcare Provider Details

I. General information

NPI: 1306612833
Provider Name (Legal Business Name): ELIZABETH BERCIER PARAMEDIC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH BERCIER NREMT/ALS

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MAIN STREET
DUNSEITH ND
58329
US

IV. Provider business mailing address

PO BOX 775
DUNSEITH ND
58329-0775
US

V. Phone/Fax

Practice location:
  • Phone: 701-244-5000
  • Fax:
Mailing address:
  • Phone: 701-244-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number106748
License Number StateND

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: