Individual
MARCIA KETTERLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP C
Contact information
Practice address
302 N MAIN ST, ELGIN, ND 58533
(701) 584-3010
(701) 584-3011
Mailing address
300 N 7TH ST, BISMARCK, ND 58501-4439
(701) 584-3011
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R17917
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19632
—
ND
01
—
23182
BLUE CROSS BLUE SHIELD
ND
Enumeration date
01/12/2007
Last updated
03/07/2023
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