Most Relevant Information
Provider Data
| NPI Number: | 1003371782 |
| Provider Name: | KYRIE MARIE SEVERSON APRN, CNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | R37913 |
Most Important Dates
| Enumeration Date: | 02/06/2019 |
| Last Updated: | 02/06/2019 |
Provider Practice Location
4622 40TH AVE S
SUITE A
FARGO
ND
58104
Practice Location Phone/Fax
| Phone: | 7013642909 |
| Fax: | 7013649822 |
Provider Mailing Location
400 E 3RD ST
DULUTH
MN
558051951
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |