Individual
MELISSA MARIE FOFANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1701 38TH ST S STE 101, FARGO, ND 58103-4499
(701) 356-1500
(701) 356-1596
Mailing address
1701 38TH ST S STE 101, FARGO, ND 58103-4499
(701) 356-1500
(701) 356-1596
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2367107
MN
363LF0000X
Family Nurse Practitioner
9983
MN
363LF0000X
Family Nurse Practitioner
Primary
R38049
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053026070
—
MN
05
—
1488848
—
ND
Enumeration date
01/16/2023
Last updated
11/26/2024
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