Mark E Koivula, FNP-C
Nurse Practitioner, Family in Bottineau, ND. Individual provider (NPI-1).
NPI number1265660740
StatusActive
Last updated in NPPESMar 18, 2022
Details
- NPI
- 1265660740
- Entity type
- Individual (NPI-1)
- Name
- Mark E Koivula
- Credential
- FNP-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2009
- Certification date
- Mar 18, 2022
- Last updated
- Mar 18, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | R26131 | ND | Yes |
Practice location
516 Main StBottineau, ND 58318-1203
Phone 701-534-0109 · Fax 866-640-0723
Mailing address
Po Box 419Bottineau, ND 58318-0401
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