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NPI Code Detail

MEDICARE: MARIA JOANN NYE

MEDICARE:   MARIA JOANN NYE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystL163ND

General Provider Information

NPI Number : 1245999473
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA JOANN NYE
Provider Business Mailing Address
First Line : 605 33RD AVE W APT 313
Second Line :
City : WEST FARGO
State : ND
Zip : 58078-7883
Country : US
Telephone Number : 612-618-8156
Fax Number :
Provider Business Practice Location Address
First Line : 4152 30TH AVE S
Second Line :
City : FARGO
State : ND
Zip : 58104-8524
Country : US
Telephone Number : 701-364-2663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2021
Last Update Date : 09/08/2025

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Directions to “ MARIA JOANN NYE ” Practice Location

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