Individual
BRITTANI ROSE BOEHLKE-FIECKE
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
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0584
ND
363AM0700X
Medical Physician Assistant
PAC0584
ND
Other
Enumeration date
03/02/2011
Last updated
12/23/2015
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