Individual
KRISTEN RENAE GOURNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3883 74TH AVENUE, FORT TOTTEN, ND 58335-5833
(701) 766-1600
Mailing address
1030 7TH ST NE, DEVILS LAKE, ND 58301-2720
(218) 280-6153
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R37632
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R37632
NORTH DAKOTA BOARD OF NURSING
ND
Enumeration date
06/11/2019
Last updated
06/11/2019
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