Individual
STEPHANIE NILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
737 BROADWAY N, FARGO, ND 58102-4421
(701) 234-5997
(701) 234-7194
Mailing address
737 BROADWAY N, FARGO, ND 58102-4421
(701) 234-5997
(701) 234-7194
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
R30561
ND
Other
Enumeration date
08/14/2009
Last updated
08/14/2009
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