Healthcare Provider Details

I. General information

NPI: 1831666197
Provider Name (Legal Business Name): JOSEPH GIRAMATA APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 07/06/2020
Certification Date: 07/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 4TH AVE S
WISHEK ND
58495-7527
US

IV. Provider business mailing address

1007 4TH AVE S
WISHEK ND
58495-7527
US

V. Phone/Fax

Practice location:
  • Phone: 701-452-2326
  • Fax:
Mailing address:
  • Phone: 701-452-2326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR46893
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: