Provider Demographics
NPI:1568996700
Name:DAHL, ALYSON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALYSON
Middle Name:
Last Name:DAHL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5621 36TH AVE S UNIT 400
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-5270
Mailing Address - Country:US
Mailing Address - Phone:701-599-3950
Mailing Address - Fax:701-495-9540
Practice Address - Street 1:5621 36TH AVE S UNIT 400
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-5270
Practice Address - Country:US
Practice Address - Phone:701-308-1429
Practice Address - Fax:701-495-9540
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPAC0853363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant