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NPI Code Detail

MEDICARE: DARREN D PAGNAC RN FIRST ASSIST

MEDICARE: DARREN D PAGNAC RN FIRST ASSIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician AssistantMN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1855921045359OTHERMNPREFFEREDONE
285637PAOTHERMNBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1801942750
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARREN D PAGNAC RN FIRST ASSIST
Provider Business Mailing Address
First Line : 3807 GREENLEAF AVE NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5817
Country : US
Telephone Number : 218-751-9746
Fax Number : 218-759-0620
Provider Business Practice Location Address
First Line : 3807 GREENLEAF AVE NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5817
Country : US
Telephone Number : 218-751-9746
Fax Number : 218-759-0620
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 07/08/2007

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Directions to “ DARREN D PAGNAC RN FIRST ASSIST” Practice Location

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