Provider Demographics
NPI:1205825593
Name:KAISER, KAREN (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KAISER
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:PO BOX 2168
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58107-2168
Mailing Address - Country:US
Mailing Address - Phone:701-234-2119
Mailing Address - Fax:
Practice Address - Street 1:420 SOUTH 7TH STREET
Practice Address - Street 2:
Practice Address - City:OAKES
Practice Address - State:ND
Practice Address - Zip Code:58474-2024
Practice Address - Country:US
Practice Address - Phone:701-742-3267
Practice Address - Fax:701-742-3201
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR14200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND28598OtherBLUE SHIELD
ND500007865OtherRAILROAD MEDICARE
ND19185OtherBLUE SHIELD
NDCF8850OtherRAILROAD MEDICARE
ND18174OtherBLUE SHIELD
ND28597OtherBLUE SHIELD
ND28599OtherBLUE SHIELD
ND18176OtherBLUE SHIELD
ND25959OtherBLUE SHIELD
ND28597OtherBLUE SHIELD
ND500007865OtherRAILROAD MEDICARE
ND500007865Medicare PIN
ND18174OtherBLUE SHIELD
ND28598OtherBLUE SHIELD