Individual
KELSEY VIVATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, APRN
Contact information
Practice address
2534 17TH AVE S STE E, GRAND FORKS, ND 58201-5215
(701) 885-4551
(701) 757-1351
Mailing address
PO BOX 5459, GRAND FORKS, ND 58206-5459
(701) 885-4551
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
11019899
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R37072
ND
Other
Enumeration date
07/20/2022
Last updated
09/18/2025
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