Healthcare Provider Details

I. General information

NPI: 1366087264
Provider Name (Legal Business Name): CHATTER PEDIATRIC WALK-IN CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 UNIVERSITY AVE STE 103
WILLISTON ND
58801-5618
US

IV. Provider business mailing address

221 UNIVERSITY AVE STE 203
WILLISTON ND
58801-5618
US

V. Phone/Fax

Practice location:
  • Phone: 701-580-8788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATIE KRINGEN
Title or Position: OWNER
Credential:
Phone: 701-580-8788