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General NPI Number Information
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NPI Number | 1083072466
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Entity Type | Individual
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Provider Name | KARI GUDMUNDSON
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Gender | Female
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Dates
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Enumeration Date | 02/01/2016
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 1451 44TH AVE S STE F
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City | GRAND FORKS
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State | ND
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Zip | 58201-3434
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Country | US
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Telephone | 701-732-2633
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Fax |
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Provider Business Mailing Address
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Address Line | 1451 44TH AVE S STE F
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City | GRAND FORKS
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State | ND
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Zip | 58201-3434
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4463
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R42729
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License Number State | ND
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