Individual
LYNETTE ROTH NYGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7400
(701) 774-7479
Mailing address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7400
(701) 774-7479
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R17884
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12693
—
ND
01
—
3553
BLUE CROSS OF ND
ND
05
—
4304043
—
MT
Enumeration date
07/12/2006
Last updated
07/08/2007
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