Healthcare Provider Details

I. General information

NPI: 1003267394
Provider Name (Legal Business Name): KAYLA L. NELSON DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA L. CHESLEY DNP, FNP-C

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 13TH AVE S
FARGO ND
58103-3403
US

IV. Provider business mailing address

3210 13TH AVE S
FARGO ND
58103-3403
US

V. Phone/Fax

Practice location:
  • Phone: 701-478-5808
  • Fax: 218-477-1354
Mailing address:
  • Phone: 701-271-3344
  • Fax: 218-477-1354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number6918
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR36365
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: