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General NPI Number Information
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NPI Number | 1588528749
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Entity Type | Individual
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Provider Name | KAYLEY KNUDSON
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Gender | Female
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 2101 ELM ST N
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City | FARGO
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State | ND
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Zip | 58102-2417
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Country | US
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Telephone | 701-239-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 S BROADWAY
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City | MINOT
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State | ND
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Zip | 58701-7420
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Country | US
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Telephone | 701-418-2600
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Fax | 701-418-1090
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | L16130
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License Number State | ND
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