Provider Demographics
NPI:1043821622
Name:HERDMAN, BYRON HOWARD (DNP, APRN, CNP)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:HOWARD
Last Name:HERDMAN
Suffix:
Gender:M
Credentials:DNP, APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 W COLFAX ST
Mailing Address - Street 2:
Mailing Address - City:PARKERS PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56361-4751
Mailing Address - Country:US
Mailing Address - Phone:701-371-5139
Mailing Address - Fax:
Practice Address - Street 1:119 30TH AVE W STE 119
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-3433
Practice Address - Country:US
Practice Address - Phone:320-762-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7491363LF0000X, 363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care