Most Relevant Information
Provider Data
| NPI Number: | 1003242256 |
| Provider Name: | WENDY M MOORE NURSE PRACTITIONER |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | R36755 |
Most Important Dates
| Enumeration Date: | 09/19/2013 |
| Last Updated: | 07/03/2018 |
Provider Practice Location
901 28TH ST S
FARGO
ND
58103
Practice Location Phone/Fax
| Phone: | 7014041100 |
| Fax: | 7015406498 |
Provider Mailing Location
901 28TH ST S
FARGO
ND
581038743
Provider Mailing Phone/Fax
| Phone: | 7014041100 |
| Fax: | 7015406498 |