Basic Information
Provider Information
NPI: 1548811169
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SKEIE
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 900 E BROADWAY AVE
Address2:  
City: BISMARCK
State: ND
PostalCode: 585014520
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 900 E BROADWAY AVE
Address2:  
City: BISMARCK
State: ND
PostalCode: 585014520
CountryCode: US
TelephoneNumber: 7015307000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/25/2019
LastUpdateDate: 09/25/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XR33451NDY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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