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General NPI Number Information
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NPI Number | 1215901228
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Entity Type | Individual
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Provider Name | LAURIE HUSTON FNP
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Gender | Female
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 1101 3RD AVE NW
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City | BEULAH
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State | ND
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Zip | 58523-6215
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Country | US
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Telephone | 701-873-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 846 45TH AVE NW
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City | HAZEN
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State | ND
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Zip | 58545-9362
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Country | US
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Telephone | 701-487-3355
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R25764
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License Number State | ND
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