Provider Demographics
NPI:1326048232
Name:NESS, CONDETTA (FNP-C)
Entity Type:Individual
Prefix:
First Name:CONDETTA
Middle Name:
Last Name:NESS
Suffix:
Gender:F
Credentials:FNP-C
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 190
Mailing Address - Street 2:
Mailing Address - City:NORTHWOOD
Mailing Address - State:ND
Mailing Address - Zip Code:58267-0190
Mailing Address - Country:US
Mailing Address - Phone:701-587-6060
Mailing Address - Fax:701-587-6009
Practice Address - Street 1:4 N PARK ST
Practice Address - Street 2:
Practice Address - City:NORTHWOOD
Practice Address - State:ND
Practice Address - Zip Code:58267-4102
Practice Address - Country:US
Practice Address - Phone:701-587-6060
Practice Address - Fax:701-587-6009
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR18461363L00000X, 363LF0000X
NDPAC0060363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
01-19170OtherMEDICA
MN102795600Medicaid
24023OtherND BCBS
MN268M8NEOtherMN BCBS
NA9481022062OtherPREFERRED ONE
ND19733Medicaid
NA9481022062OtherPREFERRED ONE
ND24023Medicare PIN