Marilyn A Kitzman, FNP, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAC0050 Issued in ND

Practice address

800 3Rd Ave SW
Rugby, ND 58368-1645

Phone

(701) 776-5235

Fax

(701) 776-5297

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 5, 2008.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1831297324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 3RD AVE SW",
            "city": "RUGBY",
            "state": "ND",
            "postal_code": "583681645",
            "telephone_number": "701-776-5235",
            "fax_number": "701-776-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 3RD AVE SW",
            "city": "RUGBY",
            "state": "ND",
            "postal_code": "583681645",
            "telephone_number": "701-776-5235",
            "fax_number": "701-776-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITZMAN",
        "first_name": "MARILYN",
        "middle_name": "A",
        "credential": "FNP, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0050",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "PAC0050",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "N4688",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.