=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396588208
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NITASHA LYNN WERLINGER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2024
-----------------------------------------------------
Last Update Date | 03/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2101 ELM ST N
-----------------------------------------------------
City | FARGO
-----------------------------------------------------
State | ND
-----------------------------------------------------
Zip | 58102-2417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-239-3700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1953 67TH AVE S
-----------------------------------------------------
City | FARGO
-----------------------------------------------------
State | ND
-----------------------------------------------------
Zip | 58104-7421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-318-2232
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WP2201X
-----------------------------------------------------
Taxonomy Name | Ambulatory Care Registered Nurse
-----------------------------------------------------
License Number | R44849
-----------------------------------------------------
License Number State | ND
-----------------------------------------------------