Individual
AMANDA J PRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 364-8906
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0487
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71077
—
ND
Enumeration date
07/23/2012
Last updated
11/05/2021
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