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Individual

BRIANNA CORTNEY KACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(507) 822-0530
Mailing address
1801 17TH ST S, FARGO, ND 58103-4835
(507) 822-0530

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
243973-4
MN
163W00000X
Registered Nurse
Primary
R44279
ND

Other

Enumeration date
07/01/2024
Last updated
07/01/2024
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