Provider Demographics
NPI:1972553675
Name:LOMSDAL, RONNIE LEE (CRNA)
Entity Type:Individual
Prefix:MR
First Name:RONNIE
Middle Name:LEE
Last Name:LOMSDAL
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:2810 2ND ST N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-1606
Mailing Address - Country:US
Mailing Address - Phone:701-232-3241
Mailing Address - Fax:701-237-2633
Practice Address - Street 1:2101 ELM ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2417
Practice Address - Country:US
Practice Address - Phone:701-232-3241
Practice Address - Fax:701-237-2633
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NDR18286367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered