Individual
KEVIN KURT AXTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 WESTPORT BEACH WAY UNIT B, WEST FARGO, ND 58078-8848
(701) 240-1758
Mailing address
1115 WESTPORT BEACH WAY UNIT B, WEST FARGO, ND 58078-8848
(701) 240-1758
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R35002
ND
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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