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Individual

MR. KINSEY BJORN NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1800 21ST AVE S, FARGO, ND 58103-5759
(701) 365-8700
(701) 365-8701
Mailing address
1800 21ST AVE S, FARGO, ND 58103-5759
(701) 365-8700
(701) 365-8701

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12048
ND
207Q00000X
Family Medicine Physician
51215
MN
207Q00000X
Family Medicine Physician
PT 12048
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1427276260
MN
05
16281
ND
Enumeration date
04/24/2007
Last updated
12/15/2022
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