Witzel, Gwen

Witzel, Gwen is an individual health care provider with primary practice located at 5225 23Rd Ave S , Fargo ND 58104-7927. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Witzel, Gwen can be contacted via phone (701) 234-2000.

Contact Information

Primary practice address
5225 23Rd Ave S Fargo ND 58104-7927
Phone: (701) 234-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R22146 North Dakota
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R22146 North Dakota

Profile Details

NPI number 1720026768
LBN Legal business name Witzel, Gwen
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated Apr 5th, 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 1720026768 NPPES
North Dakota MEDICAID 19584

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