Healthcare Provider Details

I. General information

NPI: 1679404859
Provider Name (Legal Business Name): MACEY STRICKLER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 47TH AVE S
GRAND FORKS ND
58201-7595
US

IV. Provider business mailing address

1750 47TH AVE S
GRAND FORKS ND
58201-7595
US

V. Phone/Fax

Practice location:
  • Phone: 701-757-8700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR50625
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: