Individual
GWEN P NORDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(218) 739-1400
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
(218) 739-1400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1065
MN
Other
Enumeration date
10/11/2007
Last updated
03/06/2025
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