Healthcare Provider Details

I. General information

NPI: 1124588314
Provider Name (Legal Business Name): JOANN MARY KVEUM NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 2ND AVE E
WESTHOPE ND
58793-4027
US

IV. Provider business mailing address

310 2ND AVE E
WESTHOPE ND
58793-4027
US

V. Phone/Fax

Practice location:
  • Phone: 701-245-6300
  • Fax: 855-435-5155
Mailing address:
  • Phone: 701-245-6300
  • Fax: 855-435-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR31415
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: