Healthcare Provider Details
I. General information
NPI: 1821722471
Provider Name (Legal Business Name): ALEX JAMES FJELDHEIM FNP DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/11/2022
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 N 7TH ST
OAKES ND
58474-2502
US
IV. Provider business mailing address
111 W ELM AVE
LINTON ND
58552-2100
US
V. Phone/Fax
- Phone: 701-742-3291
- Fax: 701-742-3639
- Phone: 701-254-4511
- Fax: 701-254-0112
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | R52878 |
| License Number State | ND |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: