Healthcare Provider Details

I. General information

NPI: 1902015472
Provider Name (Legal Business Name): KERRY JO UREVIG RN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. KERRY JO BIGGINS

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 N 4TH AVE
FERGUS FALLS MN
56537-1034
US

IV. Provider business mailing address

PO BOX 1182 800 5TH ST S
WALKER MN
56484
US

V. Phone/Fax

Practice location:
  • Phone: 218-998-3778
  • Fax: 218-998-3187
Mailing address:
  • Phone: 218-821-9294
  • Fax: 218-547-7232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR1050868
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: