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NPI Code Detail

MEDICARE: MIRIAM ELAINE TELL NURSE PRACTITIONER

MEDICARE: MIRIAM ELAINE TELL NURSE PRACTITIONER
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerR127204-4MN
2282N00000XGeneral Acute Care Hospital200650185NPOR
3363LP0808XPsychiatric/Mental Health Nurse Practitioner3685MN

General Provider Information

NPI Number : 1841314077
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRIAM ELAINE TELL NURSE PRACTITIONER
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number : 605-328-9419
Fax Number : 218-759-4807
Provider Business Practice Location Address
First Line : 1526 30TH ST NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-4140
Country : US
Telephone Number : 218-751-0887
Fax Number : 218-759-4807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 11/25/2024

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