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General NPI Number Information
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NPI Number | 1194594903
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Entity Type | Individual
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Provider Name | ALICIA BETH LAGARDE FNP
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Gender | Female
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Dates
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Enumeration Date | 12/21/2023
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 1001 E SUPERIOR ST STE 401
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City | DULUTH
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State | MN
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Zip | 55802-2229
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Country | US
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Telephone | 218-249-6523
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Fax | 218-249-6501
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Provider Business Mailing Address
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Address Line | 1001 E SUPERIOR ST STE 401
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City | DULUTH
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State | MN
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Zip | 55802-2229
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Country | US
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Telephone | 218-249-6523
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Fax | 218-249-6501
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10275
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License Number State | MN
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