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General NPI Number Information
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NPI Number | 1467152694
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Entity Type | Organization
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Legal Business Name | ROBIN PURSIFULL LLC
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Dates
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Enumeration Date | 03/07/2023
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1705 4TH AVE NW
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City | MINOT
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State | ND
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Zip | 58703-2912
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Country | US
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Telephone | 701-839-0474
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Fax |
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Provider Business Mailing Address
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Address Line | 3015 16TH ST SW APT 316
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City | MINOT
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State | ND
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Zip | 58701-6909
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Country | US
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Telephone | 850-543-9469
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBIN PURSIFULL
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Credential | NP
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Telephone | 850-543-9469
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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 |
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License Number State |
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