Individual
THERESA CHERYL WAVRIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1240 25TH ST S, FARGO, ND 58103-2367
(701) 241-1385
Mailing address
1240 25TH ST S, FARGO, ND 58103-2367
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R28775
ND
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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