Individual
SUSAN WARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
416 KUNDERT ST, TURTLE LAKE, ND 58575
(701) 448-9225
(701) 448-9224
Mailing address
PO BOX 535, TURTLE LAKE, ND 58575
(701) 448-9225
(701) 448-9224
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R28550
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13704
—
ND
05
—
19783
—
ND
01
—
24011
BCBS
ND
01
—
24014
BCBS
ND
01
—
25017
BCBS
ND
01
—
25018
BCBS
ND
05
—
5904
—
ND
05
—
5907
—
ND
Enumeration date
10/24/2006
Last updated
07/08/2007
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