Organization
ANOVA FAMILY HEALTH CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VONNIE JEAN JOHNSON FNP-BC (OWNER/OPERATOR)
(701) 842-6400
Entity
Organization
Contact information
Practice address
113 MAIN STREET SOUTH, WATFORD CITY, ND 58854-2479
(701) 842-6400
(701) 842-6403
Mailing address
PO BOX 2479, 113 MAIN STREET SOUTH, WATFORD CITY, ND 58854-2479
(701) 842-6400
(701) 842-6403
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124279633
INDIVIDUAL NPI-VONNIE JOHNSON
—
01
—
1790030187
INDIVIDUAL NPI-ANITA PEDERSEN
—
Enumeration date
08/31/2012
Last updated
12/14/2012
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