Provider Demographics
NPI:1114205978
Name:KREIN, GEORGIA RAE (NP)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:RAE
Last Name:KREIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14210 72ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:ND
Mailing Address - Zip Code:58722-9620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 MAIN ST S
Practice Address - Street 2:MCHS MINOT / HEARTLAND CARE PARTNERS
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4499
Practice Address - Country:US
Practice Address - Phone:800-375-5495
Practice Address - Fax:800-564-5952
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR23732363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner