Provider Demographics
NPI:1801942750
Name:PAGNAC, DARREN D (RN FIRST ASSIST)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:D
Last Name:PAGNAC
Suffix:
Gender:M
Credentials:RN FIRST ASSIST
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Mailing Address - Street 1:3807 GREENLEAF AVE NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-5817
Mailing Address - Country:US
Mailing Address - Phone:218-751-9746
Mailing Address - Fax:218-759-0620
Practice Address - Street 1:3807 GREENLEAF AVE NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5817
Practice Address - Country:US
Practice Address - Phone:218-751-9746
Practice Address - Fax:218-759-0620
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN855921045359OtherPREFFEREDONE
MN85637PAOtherBLUE CROSS BLUE SHIELD