1801696885 NPI number — MRS. NATHINA NICHOLE MYERS LMT1793

Table of content: MRS. NATHINA NICHOLE MYERS LMT1793 (NPI 1801696885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801696885 NPI number — MRS. NATHINA NICHOLE MYERS LMT1793

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MYERS
Provider First Name:
NATHINA
Provider Middle Name:
NICHOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMT1793
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ST. PIERRE
Provider Other First Name:
NATHINA
Provider Other Middle Name:
NICHOLE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMT1793
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801696885
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
113 6TH AVE SE STE 5400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WATFORD CITY
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58854-7331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-842-3100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 6TH AVE SE STE 5400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATFORD CITY
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58854-7331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-842-3100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/18/2025

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: 225700000X , with the licence number:  1793 , 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)





Copyright © 2007-2025 www.npivalidator.com