Healthcare Provider Details

I. General information

NPI: 1538790803
Provider Name (Legal Business Name): ANNE VANHEEL APRN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 23RD AVE S
FARGO ND
58104-7927
US

IV. Provider business mailing address

935 29TH AVE W
WEST FARGO ND
58078-7874
US

V. Phone/Fax

Practice location:
  • Phone: 701-417-2991
  • Fax:
Mailing address:
  • Phone: 763-639-9736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704394038
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR45603
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR45603
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: