Individual provider · Type 1 NPI
Jacob Kohl Pederson, APRN CNP
Gerontology Nurse Practitioner · Fargo, ND
NPI number
1770243727
Active
Practice location
3000 32nd Ave S
Fargo, ND 58103-6132
Mailing address
400 E 3rd St
Duluth, MN 55805-1951
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | R51672 (ND) |
Gerontology Nurse Practitioner: Definition to come...
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Other gerontology nurse practitioner providers in Fargo
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About NPI 1770243727
Jacob Kohl Pederson, APRN CNP's National Provider Identifier is 1770243727, issued on Dec 17, 2021. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Fargo, ND. The record was last updated on Dec 17, 2021.