Individual
SHANNON KITTLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
310 N 9TH ST, BISMARCK, ND 58501-4508
(701) 530-8800
(701) 530-8763
Mailing address
310 N 9TH ST, BISMARCK, ND 58501-4508
(701) 530-8800
(701) 530-8763
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R24358
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19662
—
ND
Enumeration date
07/18/2006
Last updated
06/25/2010
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