Healthcare Provider Details

I. General information

NPI: 1598622037
Provider Name (Legal Business Name): LISA K NAGEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 ALBRECHT BLVD N
FARGO ND
58105-5716
US

IV. Provider business mailing address

1002 3RD ST S
WAHPETON ND
58075-4913
US

V. Phone/Fax

Practice location:
  • Phone: 701-367-2575
  • Fax: 701-367-2575
Mailing address:
  • Phone: 701-367-2575
  • Fax: 701-367-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number118222
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberND4960
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: