Individual
LOUELLA PINEDA SIMPAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 230-3700
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
45126
MN
2084P0800X
Psychiatry Physician
9480
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
187K5S1
BCBS
MN
01
—
23695
BCBS
ND
05
—
260002202
—
ND
05
—
751142600
—
MN
Enumeration date
09/29/2006
Last updated
02/27/2025
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