Patricia Well
Individual provider Active NPI Pharmacist · Lisbon, ND
NPI 1508243106 · NPPES record last updated May 3, 2015
Key facts
- NPI
- 1508243106
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 4176 (ND)
- Practice address
- 407 Main St
Lisbon, ND 58054-4143 - Phone
- (701) 683-5282
- NPI assigned
- May 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|
| 4176 | ND | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nudak Ventures North Dakota LLC | Past | Accepting new patients | |
| Nudak Ventures North Dakota, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4176 | ND | Yes |
Addresses
Primary practice location
407 Main St
Lisbon, ND 58054-4143
Mailing address
PO Box 706
Lisbon, ND 58054-0706
Phone (701) 683-0124
Other providers in Lisbon, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2015. 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.