Individual
KIMBERLY R NEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
ALTRU CANCER CENTER, 960 S. COLUMBIA ROAD, GRAND FORKS, ND 58201-4036
(701) 780-5000
(304) 781-5139
Mailing address
PO BOX 13780, GRAND FORKS, ND 58208
(701) 780-1891
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
83344
WV
363LA2100X
Acute Care Nurse Practitioner
201611
ND
363LA2200X
Adult Health Nurse Practitioner
201611
ND
363LG0600X
Gerontology Nurse Practitioner
Primary
201611
ND
Other
Enumeration date
01/19/2016
Last updated
05/16/2025
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