NPI 1972132249 · live from the CMS NPI Registry
Kalee Irene Wysuph, APRN,CNP
Nurse Practitioner, Pediatrics in Fargo, ND. National Provider Identifier 1972132249, active.
NPI record
| NPI | 1972132249 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 1702 University Dr S, Fargo, ND 58103 |
| Practice phone | 701-364-3300 |
| Mailing address | Ssb-6, 400 E 3rd St, Duluth, MN 55805 |
| Enumerated | April 7, 2020 |
| Last updated | April 28, 2021 |
| Sole proprietor | No |
| Other names | Kalee Sullivan |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Nurse Practitioner, Pediatrics primary | 363LP0200X | R42839 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.