Individual
KRISTINA M CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
(701) 364-8078
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2934
MN
363LF0000X
Family Nurse Practitioner
Primary
R30216
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1460305
—
ND
Enumeration date
06/30/2014
Last updated
05/28/2020
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