Individual
NINA WENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-5621
(701) 234-7334
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R31181
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16728
—
ND
Enumeration date
01/26/2012
Last updated
09/21/2012
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