Individual
AMY GOTVASLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1040 TACOMA AVE, BISMARCK, ND 58504-7452
(701) 323-6990
(701) 323-6950
Mailing address
PO BOX 2010, FARGO, ND 58122-2484
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R31841
ND
363LF0000X
Family Nurse Practitioner
Primary
R31841
ND
Other
Enumeration date
06/02/2014
Last updated
05/29/2019
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