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Individual

MR. KEVIN RAY CLEMANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
2305 37TH AVE SW, MINOT, ND 58701-7669
(701) 857-5000
Mailing address
PO BOX 5010, MINOT, ND 58702-5010
(701) 418-8000
(701) 857-3430

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
71004655A
IN
363LF0000X
Family Nurse Practitioner
Primary
R50536
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000959186
ANTHEM BCBS
IN
01
000001037665
ANTHEM BCBS- SJCTS
IN
01
000001133913
ANTHEM
IN
05
201263850
IN
01
IN1041012
MEDICARE-SJCTS
IN
01
P01734831
RR PTAN
IN
Enumeration date
07/16/2013
Last updated
09/23/2025
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