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Organization
RENEW PSYCHIATRY LLC
Active
Organization
RENEW PSYCHIATRY LLC
Active
Other names
Renew Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS UGELSTAD PMHNP (NURSE PRACTITIONER)
(701) 251-0551
Entity
Organization
Contact information
Practice address
4656 AMBER VALLEY PKWY S, FARGO, ND 58104-4593
(701) 552-2325
Mailing address
2626 PACIFIC DR S APT 301, FARGO, ND 58103-5547
(701) 251-0551
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
10/13/2024
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