Individual provider · NPI-1

Crystal Ann Magsam Amundson, PA-C

Physician Assistant · Fargo, ND

NPI number1659941318
StatusActive
Last updated in NPPESFeb 16, 2022

Details

NPI
1659941318
Entity type
Individual (NPI-1)
Name
Crystal Ann Magsam Amundson
Credential
PA-C
Sex
Female
Sole proprietor
No
Enumeration date
Jun 25, 2021
Certification date
Dec 15, 2021
Last updated
Feb 16, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician AssistantPAC0918NDYes
363A00000X Physician Assistant13928MN

Practice location

3902 13th Ave S
Fargo, ND 58103-3357

Phone 701-364-6600

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

Phone 701-364-8000

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