Individual
KAYLA MARIE WEIGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 BROADWAY N, FARGO, ND 58102-1406
(701) 234-2900
Mailing address
4785 44TH ST S, FARGO, ND 58104-4284
(701) 866-2946
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
R36567
ND
363LF0000X
Family Nurse Practitioner
Primary
R36567
ND
Other
Enumeration date
03/18/2018
Last updated
11/14/2018
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