Healthcare Provider Details

I. General information

NPI: 1275984635
Provider Name (Legal Business Name): CARLA ABERLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 06/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 2ND AVE NE
JAMESTOWN ND
58401-3373
US

IV. Provider business mailing address

9905 76TH ST SE
LAMOURE ND
58458-9052
US

V. Phone/Fax

Practice location:
  • Phone: 701-251-6000
  • Fax:
Mailing address:
  • Phone: 701-883-4350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR29092
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: