ETHAN AXTMAN
Individual Provider (NPI-1)
Active
Nurse Practitioner
Provider Information
- NPI Number
1407419419- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1300 ANNE ST NW, BEMIDJI, MN, 566015103
- Phone
- (218) 333-5000
Specialties & Taxonomies
Nurse Practitioner, Family
License: IA #A145482
Nurse Practitioner
Primary License: MN #2472321
All Addresses
MAILING
PO BOX 5074
SIOUX FALLS, SD, 571175074