Most Relevant Information
Provider Data
| NPI Number: | 1003004318 |
| Provider Name: | GWEN P NORDAHL PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 1065 |
Most Important Dates
| Enumeration Date: | 10/11/2007 |
| Last Updated: | 07/09/2010 |
Provider Practice Location
712 SOUTH CASCADE STREET
FERGUS FALLS
MN
565372813
Practice Location Phone/Fax
| Phone: | 2187368000 |
| Fax: | 2187368757 |
Provider Mailing Location
712 SOUTH CASCADE STREET
FERGUS FALLS
MN
565372813
Provider Mailing Phone/Fax
| Phone: | 2187368000 |
| Fax: | 2187368757 |