Individual
MS. DEBRA K. VIVATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN ACNP-C
Contact information
Practice address
201 EAST 3RD AVE S, CAVALIER, ND 58220
(701) 780-5000
Mailing address
PO BOX 6002, GRAND FORKS, ND 58206-6002
(701) 780-5000
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R22555
ND
Other
Enumeration date
11/29/2011
Last updated
10/11/2012
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