1225268469 NPI number — CHRISTINE S LAUZON FNP-C

Table of content: CHRISTINE S LAUZON FNP-C (NPI 1225268469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225268469 NPI number — CHRISTINE S LAUZON FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAUZON
Provider First Name:
CHRISTINE
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GROHN
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
S
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225268469
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2401 DEMERS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND FORKS
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-780-1891
Provider Business Mailing Address Fax Number:
701-780-1631

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1380 S COLUMBIA RD - ALTRU FAMILY MEDICINE CENTER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND FORKS
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-795-2000
Provider Business Practice Location Address Fax Number:
701-780-1631
Provider Enumeration Date:
07/22/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LX0001X , with the licence number:  R27387 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: R27387 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)