Healthcare Provider Details

I. General information

NPI: 1740008093
Provider Name (Legal Business Name): RENEE PINDER APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RENEE CASSELS

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 2ND AVE NE
ROLLA ND
58367-7153
US

IV. Provider business mailing address

818 5TH ST
LANGDON ND
58249-2508
US

V. Phone/Fax

Practice location:
  • Phone: 701-477-3161
  • Fax:
Mailing address:
  • Phone: 816-988-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR51647
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: