Provider Demographics
NPI:1689197162
Name:GRESETH, SHEILA RENEE (DNP, NP-C)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:RENEE
Last Name:GRESETH
Suffix:
Gender:F
Credentials:DNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 LIND BLVD
Mailing Address - Street 2:
Mailing Address - City:HARWOOD
Mailing Address - State:ND
Mailing Address - Zip Code:58042-4125
Mailing Address - Country:US
Mailing Address - Phone:218-296-0975
Mailing Address - Fax:
Practice Address - Street 1:2400 32ND AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103
Practice Address - Country:US
Practice Address - Phone:218-296-0975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR39415363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner