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NPI Code Detail

MEDICARE: KATIE R HEGARTY

MEDICARE:   KATIE R HEGARTY
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1689524092
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE R HEGARTY
Provider Business Mailing Address
First Line : 2624 9TH AVE S
Second Line :
City : FARGO
State : ND
Zip : 58103-2350
Country : US
Telephone Number : 701-630-1890
Fax Number :
Provider Business Practice Location Address
First Line : 2624 9TH AVE S
Second Line :
City : FARGO
State : ND
Zip : 58103-2350
Country : US
Telephone Number : 701-630-1890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 05/21/2026

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Directions to “ KATIE R HEGARTY ” Practice Location

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