Individual
NIKOLE MARIE MOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2101 ELM ST. NE, FARGO, ND 58102
(218) 755-6360
Mailing address
2101 ELM ST. NE, FARGO, ND 58102
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
762377
MN
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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