Healthcare Provider Details

I. General information

NPI: 1255291704
Provider Name (Legal Business Name): MEGAN FIX
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S PENN ST STE 105
ABERDEEN SD
57401-4553
US

IV. Provider business mailing address

711 KERSTEN ST
BOTTINEAU ND
58318-1435
US

V. Phone/Fax

Practice location:
  • Phone: 605-622-8700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP003956
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: