Healthcare Provider Details

I. General information

NPI: 1457513905
Provider Name (Legal Business Name): MICHELLE LYNN KRAFT RN CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 ELM ST N
FARGO ND
58102-2417
US

IV. Provider business mailing address

2101 ELM ST N
FARGO ND
58102-2417
US

V. Phone/Fax

Practice location:
  • Phone: 701-239-3700
  • Fax: 701-221-0918
Mailing address:
  • Phone: 701-239-3700
  • Fax: 701-221-0918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR28517
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: