Healthcare Provider Details

I. General information

NPI: 1750206744
Provider Name (Legal Business Name): SIERRA MICHELLE WALDRON APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 N 7TH ST
BISMARCK ND
58501-4441
US

IV. Provider business mailing address

260 ALLEN ST
DICKINSON ND
58601-4041
US

V. Phone/Fax

Practice location:
  • Phone: 701-323-5590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number205706
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: