Individual provider · NPI-1

Sidney R Johnk, APRN,CNP

Nurse Practitioner, Pediatrics · Fargo, ND

NPI number1992406656
StatusActive
Last updated in NPPESMar 10, 2023

Details

NPI
1992406656
Entity type
Individual (NPI-1)
Name
Sidney R Johnk
Credential
APRN,CNP
Sex
Female
Sole proprietor
No
Enumeration date
Mar 10, 2023
Certification date
Mar 10, 2023
Last updated
Mar 10, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsR42226NDYes

Practice location

4110 51st Ave S
Fargo, ND 58104-7776

Phone 701-364-3100

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

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