Individual
MISS GINA MARIE KINZLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4840 23RD AVE S, FARGO, ND 58104-9136
(701) 356-6295
Mailing address
3310 MONROE ST S, FARGO, ND 58104-6985
(701) 793-4858
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R28725
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R28725
NP LICENSE
ND
Enumeration date
05/15/2020
Last updated
05/15/2020
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