Healthcare Provider Details

I. General information

NPI: 1215393087
Provider Name (Legal Business Name): KRISTIN APPEL LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 30TH AVE S STE 102
MOORHEAD MN
56560-5000
US

IV. Provider business mailing address

4227 9TH AVE S
FARGO ND
58103-2018
US

V. Phone/Fax

Practice location:
  • Phone: 218-979-4475
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number5190
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: