NPI 1265093124 · live from the CMS NPI Registry
Mckenzie Ann Disrud, FNP
Nurse Practitioner, Family in Grand Forks, ND. National Provider Identifier 1265093124, active.
NPI record
| NPI | 1265093124 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 2100 S Columbia Rd Ste 114, Grand Forks, ND 58201 |
| Practice phone | 701-516-4637 |
| Mailing address | Po Box 13238, Grand Forks, ND 58208 |
| Enumerated | June 21, 2019 |
| Last updated | January 30, 2025 |
| Sole proprietor | No |
| Other names | Mckenzie Brown |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Surgical | 363AS0400X | — |
| Nurse Practitioner, Family | 363LF0000X | F06191893 (ND) |
| Nurse Practitioner, Family primary | 363LF0000X | RH1306 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.