Individual
BETHANN MARIE NUELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4700 S WASHINGTON ST, GRAND FORKS, ND 58201-8123
(701) 757-2559
Mailing address
4700 S WASHINGTON ST, GRAND FORKS, ND 58201-8123
(701) 757-2559
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R25291
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025553
BCBS ND
ND
05
—
19831
—
ND
01
—
309S5NU
BCBS MN
MN
01
—
5613280001
ADMINISTAR
—
01
—
P00263990
RR MEDICARE
—
Enumeration date
01/30/2006
Last updated
02/17/2021
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