Healthcare Provider Details

I. General information

NPI: 1245419951
Provider Name (Legal Business Name): DEBORAH BUXA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH MERTZ

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 BREWSTER ST E
HARVEY ND
58341
US

IV. Provider business mailing address

317 BREWSTER ST E
HARVEY ND
58341-1653
US

V. Phone/Fax

Practice location:
  • Phone: 701-324-5131
  • Fax: 701-324-5126
Mailing address:
  • Phone: 701-324-5131
  • Fax: 701-324-5126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR28181
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: