Individual
MARK BJORNSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
737 BROADWAY N, FARGO, ND 58102-4421
(701) 234-2331
Mailing address
737 BROADWAY N, FARGO, ND 58102-4421
(701) 234-2331
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R31681
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376853945
—
MN
Enumeration date
10/18/2010
Last updated
01/10/2011
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