Provider Demographics
NPI:1447033105
Name:FINGARSON, MIKAYLA BETH (PHARMD)
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:BETH
Last Name:FINGARSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13071 78TH ST NE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:ND
Mailing Address - Zip Code:58227-9639
Mailing Address - Country:US
Mailing Address - Phone:701-331-2831
Mailing Address - Fax:
Practice Address - Street 1:38 E 12TH ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-2212
Practice Address - Country:US
Practice Address - Phone:701-352-0831
Practice Address - Fax:701-352-1910
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH6507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist