NPI Code Details Logo

NPI 1720942139

NPI 1720942139 : SIERRA ALIEDA TERGESEN : FARGO, ND

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1720942139
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    SIERRA ALIEDA TERGESEN
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/10/2025
-----------------------------------------------------
    Last Update Date     |    12/10/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2400 32ND AVE S STE 4 
-----------------------------------------------------
    City                 |    FARGO
-----------------------------------------------------
    State                |    ND
-----------------------------------------------------
    Zip                  |    58103-5804
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    701-234-9912
-----------------------------------------------------
    Fax                  |    701-297-0807
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2400 32ND AVE S STE 4 
-----------------------------------------------------
    City                 |    FARGO
-----------------------------------------------------
    State                |    ND
-----------------------------------------------------
    Zip                  |    58103-5804
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    701-234-9912
-----------------------------------------------------
    Fax                  |    701-297-0807
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    172V00000X
-----------------------------------------------------
    Taxonomy Name        |    Community Health Worker
-----------------------------------------------------
    License Number       |    49177
-----------------------------------------------------
    License Number State |    ND
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.