James Merle Gullekson, LMT
Individual provider Active NPI Massage Therapist · Fargo, ND
NPI 1013603174 · NPPES record last updated Apr 12, 2023
Key facts
- NPI
- 1013603174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 22146 (ND)
- Practice address
- 4501 15TH Ave S Ste 104
Fargo, ND 58103-8956 - Phone
- (701) 446-8833
- NPI assigned
- Apr 12, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014874 | MN | MD | Registered Nurse |
| R31784 | ND | MD | Registered Nurse |
| 22146 | ND | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R31784 | ND | |
| Registered Nurse | 163W00000X | 2014874 | MN | |
| Massage Therapist | 225700000X | 22146 | ND | Yes |
Addresses
Primary practice location
4501 15TH Ave S Ste 104
Fargo, ND 58103-8956
Mailing address
4501 15TH Ave S Ste 104
Fargo, ND 58103-8956
Phone (701) 446-8833
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- Carissa Guler
- Madison Mae Guler
- Jean L Gullicks
- Nicole M. Gullickson
- Shannon Lynn Gullingsrud
- Alisha Gumbleton
- Aaron C Gunderson
All providers in Fargo, ND · Massage Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.