Individual
ERIC PAUL LEEDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
Mailing address
4742 51ST ST S, FARGO, ND 58104-6016
(701) 866-8763
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R46122
ND
163WC0200X
Critical Care Medicine Registered Nurse
R46122
ND
163WE0003X
Emergency Registered Nurse
R46122
ND
Other
Enumeration date
03/07/2024
Last updated
06/13/2025
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