Organization
INNOVIS HEALTH, LLC
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health The Lights West Fargo Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
ALAN HURLEY (COO)
(701) 364-7667
Entity
Organization
Contact information
Practice address
3150 SHEYENNE ST STE 240, WEST FARGO, ND 58078-8546
(701) 364-1530
(701) 364-1531
Mailing address
1702 UNIVERSITY DR S, ATN: MEDICAL STAFF SERVICES-SSC, FARGO, ND 58103-4940
(701) 364-8177
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2022
Last updated
03/01/2024
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