Healthcare Provider Details

I. General information

NPI: 1164945994
Provider Name (Legal Business Name): CARLEE LYNN THOMSON DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2017
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 HIGHWAY 2 W STE 8
DEVILS LAKE ND
58301-2913
US

IV. Provider business mailing address

210 US HIGHWAY 2 WEST SUITE 8 210 US HIGHWAY 2 WEST SUITE 8
DEVILS LAKE ND
58301
US

V. Phone/Fax

Practice location:
  • Phone: 701-662-2039
  • Fax: 701-662-2049
Mailing address:
  • Phone: 701-662-2039
  • Fax: 701-662-2049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR29332
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: