Individual
MRS. MARY D WIERSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1200 S COLUMBIA RD, GRAND FORKS, ND 58206-6002
(701) 780-5000
(701) 780-1942
Mailing address
PO BOX 6002, GRAND FORKS, ND 58206-6002
(701) 780-5000
(701) 780-1942
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
R-062311-5
MN
Other
Enumeration date
08/14/2007
Last updated
08/14/2007
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