Individual
BREANNA DINAE MOHAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1701 38TH ST S, FARGO, ND 58103-4499
(701) 356-1600
Mailing address
2915 BLUESTEM DR APT 3199, WEST FARGO, ND 58078-8046
(701) 936-5488
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R40018
ND
Other
Enumeration date
02/09/2022
Last updated
02/09/2022
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