# INNOVIS HEALTH, LLC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ESSENTIA HEALTH
- **Other names:** Essentia Health Wahpeton Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790965440
- **Legal business name:** ESSENTIA HEALTH
- **Authorized official:** ALAN HURLEY (COO)
- **Authorized official phone:** (701) 364-7667

## Contact information

- **Practice address:** 275 11TH ST S, WAHPETON, ND 58075-4655
- **Practice address phone:** (701) 642-2000
- **Practice address fax:** (701) 671-4153
- **Mailing address:** 275 11TH ST S, WAHPETON, ND 58075-4655
- **Mailing address phone:** (701) 642-2000
- **Mailing address fax:** (701) 671-4153

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/10/2007
- **Last updated:** 03/01/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 046927000 | — | MN |