Individual
LORNA JOY IHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2371
(701) 234-3813
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0207
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71081
—
ND
Enumeration date
07/17/2006
Last updated
02/04/2015
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