Most Relevant Information
Provider Data
| NPI Number: | 1003643487 |
| Provider Name: | MARY OMER HABIB APRN, CNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 2529836 |
Most Important Dates
| Enumeration Date: | 09/18/2024 |
| Last Updated: | 09/18/2024 |
Provider Practice Location
4622 40TH AVE S STE A
FARGO
ND
581044394
Practice Location Phone/Fax
| Phone: | 2183648900 |
| Fax: |
Provider Mailing Location
400 E 3RD ST
SSB-6
DULUTH
MN
558051951
Provider Mailing Phone/Fax
| Phone: | 2187868364 |
| Fax: |