Provider Demographics
NPI:1467201954
Name:RESURGENT HEALTH, PLLC
Entity type:Organization
Organization Name:RESURGENT HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHL
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:701-308-1429
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:701-599-3950
Practice Address - Fax:701-495-9540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty