Organization
MINOT HEALTH CLINIC, PLLC
Active
Other names
Minot Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TRISHA FENNERN FNP-C (OWNER/PRACTITIONER)
(701) 837-1551
Entity
Organization
Contact information
Practice address
1021 20TH AVE SW STE 113, MINOT, ND 58701-6487
(701) 837-1551
Mailing address
1021 20TH AVE SW STE 113, MINOT, ND 58701-6487
(701) 837-1551
(701) 837-1540
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
R30827
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013220490
BCBS
ND
01
—
715283
MEDICARE
ND
05
—
84015
—
ND
Enumeration date
03/24/2014
Last updated
02/08/2021
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