=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962375840
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARI ELY FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2025
-----------------------------------------------------
Last Update Date | 10/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 810 N WELO ST
-----------------------------------------------------
City | TIOGA
-----------------------------------------------------
State | ND
-----------------------------------------------------
Zip | 58852-7157
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-664-3305
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 810 N WELO ST
-----------------------------------------------------
City | TIOGA
-----------------------------------------------------
State | ND
-----------------------------------------------------
Zip | 58852-7157
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-664-3305
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 203554
-----------------------------------------------------
License Number State | ND
-----------------------------------------------------