Provider Demographics
NPI:1982861647
Name:HARSELL, CHRISTINE (ANP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:HARSELL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S 4TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4781
Mailing Address - Country:US
Mailing Address - Phone:701-757-2100
Mailing Address - Fax:701-757-0305
Practice Address - Street 1:212 S 4TH ST STE 301
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4776
Practice Address - Country:US
Practice Address - Phone:701-757-2100
Practice Address - Fax:701-757-0305
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR31123363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1982861647OtherPREFERRED ONE
ND19910Medicaid
MN1982861647Medicaid
04-11646OtherMEDICA
ND1982861647OtherND BCBS
MN1982861647OtherMN BCBS
MN1982861647OtherMN BCBS