Individual
NATHAN M SPICER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1200 S COLUMBIA RD, GRAND FORKS, ND 58201-4012
(701) 780-5000
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1399
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
R29500
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14476
—
ND
Enumeration date
11/05/2007
Last updated
10/23/2019
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