Kjos, Vicki L

Kjos, Vicki L is an individual health care provider with primary practice located at 3902 13Th Ave S , Fargo ND 58103. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Kjos, Vicki L can be contacted via phone (701) 364-6600.

Contact Information

Primary practice address
3902 13Th Ave S Fargo ND 58103
Phone: (701) 364-6600
Fax: (701) 364-6628
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5243 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9326 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0224 North Dakota

Profile Details

NPI number 1982621454
LBN Legal business name Kjos, Vicki L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Aug 20th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982621454 NPPES
Arizona MEDICAID 744746

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