Provider Demographics
NPI:1487824132
Name:GIGSTAD, ERIN NICOLE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:NICOLE
Last Name:GIGSTAD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3559 BUCHANAN ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-7508
Mailing Address - Country:US
Mailing Address - Phone:701-212-1806
Mailing Address - Fax:
Practice Address - Street 1:1417 6TH ST S
Practice Address - Street 2:CLARA BARTON ELEMENTARY
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4209
Practice Address - Country:US
Practice Address - Phone:701-446-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND939235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist