Healthcare Provider Details

I. General information

NPI: 1720376452
Provider Name (Legal Business Name): KATHARYN A BURGARDT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BURDICK EXPY E
MINOT ND
58701-4768
US

IV. Provider business mailing address

PO BOX 5010
MINOT ND
58702-5010
US

V. Phone/Fax

Practice location:
  • Phone: 701-857-7380
  • Fax: 701-857-7014
Mailing address:
  • Phone: 701-418-8000
  • Fax: 701-857-3430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR36194
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR36194
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: