Individual
BEVERLY JEANNE GREENWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC NP-C
Contact information
Practice address
117 22 ST S, FARGO, ND 58103
(701) 261-4795
Mailing address
1610 5TH AVE S, FARGO, ND 58103
(701) 261-4795
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R 158784-9
MN
363LF0000X
Family Nurse Practitioner
Primary
R22718
ND
Other
Enumeration date
06/22/2009
Last updated
06/16/2014
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