Individual provider · NPI-1

Nicole Lynn Amsbaugh, PA-C

Physician Assistant · Fargo, ND

NPI number1811194491
StatusActive
Last updated in NPPESFeb 28, 2025

Details

NPI
1811194491
Entity type
Individual (NPI-1)
Name
Ms. Nicole Lynn Amsbaugh
Credential
PA-C
Sex
Female
Sole proprietor
No
Enumeration date
Jun 28, 2007
Certification date
Feb 28, 2025
Last updated
Feb 28, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician AssistantPAC0369NDYes
363A00000X Physician Assistant7876AZ

Practice location

2400 32nd Ave S
Fargo, ND 58103-5800

Phone 701-234-2000

Mailing address

Po Box 5074
Sioux Falls, SD 57117-5074

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