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General NPI Number Information
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NPI Number | 1205662491
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Entity Type | Individual
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Provider Name | NATHANIEL FOX DNAP, CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 900 E BROADWAY AVE
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City | BISMARCK
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State | ND
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Zip | 58501-4520
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Country | US
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Telephone | 701-530-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 3822 CLAIRMONT RD
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City | BISMARCK
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State | ND
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Zip | 58503-9084
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Country | US
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Telephone | 843-315-9785
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 200981
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License Number State | ND
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