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Individual

LINDA FAYE GOURNEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
300 W CENTURY AVE, BISMARCK, ND 58503-1401
(701) 323-9900
(701) 323-9911
Mailing address
300 W CENTURY AVE, BISMARCK, ND 58503-1401
(701) 323-9900
(701) 323-9911

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6022
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27069
BLUE CROSS/BLUE SHIELD
ND
Enumeration date
08/21/2006
Last updated
10/02/2007
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