Individual
RYAN WISECARVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 471-2609
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 471-2609
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
NURR37729
AK
Other
Enumeration date
11/29/2024
Last updated
11/29/2024
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