Individual provider · Type 1 NPI

Nicole Elizabeth Fogt, PA-C

Medical Physician Assistant · St. Cloud, MN

NPI number 1770909749 Active

Practice location

1200 6th Ave N, Centracare Clinic
St. Cloud, MN 56303-2735

Call (320) 656-7020 Map

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X11514 (MN)
Medical Physician Assistant Primary 363AM0700X11514 (MN)

Medical Physician Assistant: Definition to come...

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About NPI 1770909749

Nicole Elizabeth Fogt, PA-C's National Provider Identifier is 1770909749, issued on Mar 13, 2014. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in St. Cloud, MN. The record was last updated on Apr 1, 2014.