Individual
DESIREE JOANNE GAGNER-TJELLESEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RNCS,APRN,BC
Contact information
Practice address
151 S 4TH ST, SUITE 401, GRAND FORKS, ND 58201-4715
(701) 795-3000
(701) 795-3050
Mailing address
151 S 4TH ST, SUITE 401, GRAND FORKS, ND 58201-4715
(701) 795-3000
(701) 795-3050
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
R24745
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020043
BCBS ND PROVIDER NUMBER
ND
05
—
054519
—
ND
01
—
638R1GA
BCBS MN PROVIDER NUMBER
MN
Enumeration date
06/06/2006
Last updated
03/07/2023
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