Individual
WENDY M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
901 28TH ST S, FARGO, ND 58103
(701) 404-1100
(701) 540-6498
Mailing address
901 28TH ST S, FARGO, ND 58103-8743
(701) 404-1100
(701) 540-6498
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R36755
ND
Other
Enumeration date
09/19/2013
Last updated
07/03/2018
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