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General NPI Number Information
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NPI Number | 1891825733
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Entity Type | Individual
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Provider Name | MARYANN GOLD NP
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 2615 FAIRWAY ST
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City | DICKINSON
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State | ND
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Zip | 58601-2590
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Country | US
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Telephone | 701-456-6000
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Fax | 701-483-5018
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Provider Business Mailing Address
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Address Line | PO BOX 5074
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City | SIOUX FALLS
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State | SD
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Zip | 57117-5074
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Country | US
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Telephone | 605-328-9419
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Fax | 701-483-5018
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 170319
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R19655
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R19655
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License Number State | ND
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