| NPI | 1184498834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYRIE MARIE SEVERSON Nurse Practitioner 701-426-9109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2024-02-15 |