Provider Demographics
NPI:1033233150
Name:MCPHERSON, NANCY L (PA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:8412 39TH ST SW
Mailing Address - City:RICHARDSON
Mailing Address - State:ND
Mailing Address - Zip Code:58652
Mailing Address - Country:US
Mailing Address - Phone:701-974-3820
Mailing Address - Fax:
Practice Address - Street 1:603 EAST ST NORTH
Practice Address - Street 2:JACOBSON MEMORIAL HOSPITAL CARE CENTER
Practice Address - City:ELGIN
Practice Address - State:ND
Practice Address - Zip Code:58533
Practice Address - Country:US
Practice Address - Phone:701-584-3338
Practice Address - Fax:701-584-3048
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NDPACO110363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDMM0248143OtherDEA
NDN711893Medicare ID - Type Unspecified
R02375Medicare UPIN