Individual
CRYSTAL ANN MAGSAM AMUNDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3902 13TH AVE S, FARGO, ND 58103-3357
(701) 364-6600
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
13928
MN
363A00000X
Physician Assistant
Primary
PAC0918
ND
Other
Enumeration date
06/25/2021
Last updated
02/16/2022
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