Doctor Name: | JUDY A BELLANGER-DAHL |
NPI Number: | 1265470447 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 0325 |
Business Practice Address: | 665 3rd St Sw Perham, MN - 565731108 |
Business Phone Number: | 2183474040 |
Business Fax Number: | 2183474043 |
Mailing Address: | 665 3rd St Sw, PERHAM |
State: | MN |
Postal Code: | 565731108 |
Phone Number: | 2183474040 |
Fax Number: | 2183474043 |
NPI Enumeration Date: | 06/02/2006 |
NPI Last Update Date: | 05/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 0325 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ND |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |