Healthcare Provider Details

I. General information

NPI: 1770296477
Provider Name (Legal Business Name): CRISTINA BABIC FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2022
Last Update Date: 12/28/2022
Certification Date: 12/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 UNIVERSITY AVE STE 102
WILLISTON ND
58801-5618
US

IV. Provider business mailing address

221 UNIVERSITY AVE STE 102
WILLISTON ND
58801-5618
US

V. Phone/Fax

Practice location:
  • Phone: 701-609-2004
  • Fax:
Mailing address:
  • Phone: 701-609-2004
  • Fax: 406-206-7337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR49759
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: