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Individual

MS. ELLEN LOUISE ZAESKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, LICSW

Contact information

Practice address
1112 NODAK DR S, FARGO, ND 58103-2366
(701) 232-6224
(701) 232-4687
Mailing address
1112 NODAK DR S, FARGO, ND 58103-2366
(701) 232-6224
(701) 232-4687

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6985
MN
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
R 124683-4
MN
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
R20158
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
536527900
MN
Enumeration date
11/16/2006
Last updated
08/08/2019
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