Individual
FAITH MARIE NYBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
400 E 3RD ST, DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-3443
Mailing address
400 E 3RD ST, DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-3443
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10235
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972638757
—
MN
Enumeration date
02/22/2007
Last updated
10/23/2020
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