Provider Demographics
NPI:1710545231
Name:PUBLIC HEALTH NURSING
Entity type:Organization
Organization Name:PUBLIC HEALTH NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:3RD PARTY BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PELTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-766-1667
Mailing Address - Street 1:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:FORT TOTTEN
Mailing Address - State:ND
Mailing Address - Zip Code:58335-0480
Mailing Address - Country:US
Mailing Address - Phone:701-766-4236
Mailing Address - Fax:701-766-4878
Practice Address - Street 1:816 3RD AVE N
Practice Address - Street 2:
Practice Address - City:FORT TOTTEN
Practice Address - State:ND
Practice Address - Zip Code:58335-9998
Practice Address - Country:US
Practice Address - Phone:701-766-4236
Practice Address - Fax:701-766-4878
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPIRIT LAKE TRIBE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-30
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or LocalGroup - Multi-Specialty