Provider Demographics
NPI:1649355157
Name:DAKOTA OSTEOPOROSIS INC
Entity type:Organization
Organization Name:DAKOTA OSTEOPOROSIS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:701-258-9418
Mailing Address - Street 1:705 E MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4525
Mailing Address - Country:US
Mailing Address - Phone:701-258-9418
Mailing Address - Fax:701-258-9423
Practice Address - Street 1:705 E MAIN AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4525
Practice Address - Country:US
Practice Address - Phone:701-258-9418
Practice Address - Fax:701-258-9423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR25050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty