Healthcare Provider Details

I. General information

NPI: 1871214833
Provider Name (Legal Business Name): KELSEY RAE DUCHSHERER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY RAE ADAMS

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 21ST AVE SE
MINOT ND
58701-6064
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 701-500-5476
  • Fax:
Mailing address:
  • Phone: 605-328-6585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR42473
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberR42473
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: