Samantha Jo Fugleberg
Nurse Practitioner, Family in Fargo, ND. Individual provider (NPI-1).
NPI number1497489751
StatusActive
Last updated in NPPESApr 12, 2023
Details
- NPI
- 1497489751
- Entity type
- Individual (NPI-1)
- Name
- Samantha Jo Fugleberg
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 13, 2022
- Certification date
- Apr 12, 2023
- Last updated
- Apr 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | R36750 | ND | Yes |
| 363L00000X | Nurse Practitioner | R36750 | ND |
Practice location
801 Broadway N Fl 3Fargo, ND 58102-3641
Phone 701-234-4800
Mailing address
Po Box 5074Sioux Falls, SD 57117-5074
Phone 605-328-6585
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