| Anna Rose Wiemken, NP | |
| 
					1665 43rd St S Ste 101, Fargo, ND 58103-3316  | |
| (701) 866-0561 | |
| Not Available | 
| Full Name | Anna Rose Wiemken | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 1665 43rd St S Ste 101, Fargo, North Dakota | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1982433082 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 200289 (North Dakota) | Primary | 
| Entity Name | Legacy Medical Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1619594637 PECOS PAC ID: 0648698290 Enrollment ID: O20200914001248  | 
| Entity Name | Legacy Primary Care Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1265277115 PECOS PAC ID: 5799223491 Enrollment ID: O20240813001785  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Anna Rose Wiemken, NP 1665 43rd St S Ste 101, Fargo, ND 58103-3316 Ph: (701) 866-0561  | Anna Rose Wiemken, NP 1665 43rd St S Ste 101, Fargo, ND 58103-3316 Ph: (701) 866-0561  | 
Wendy M Moore, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 901 28th St S, Fargo, ND 58103 Phone: 701-404-1100 Fax: 701-540-6498  | |
Mrs. Kayla L. Nelson, DNP, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 301 Np Ave N, Fargo, ND 58102 Phone: 701-271-3344  | |
Kyrie Marie Severson, APRN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4622 40th Ave S, Suite A, Fargo, ND 58104 Phone: 701-364-2909 Fax: 701-364-9822  | |
Jessica Smolen, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 321 8th Ave N, Fargo, ND 58102 Phone: 701-234-2525  | |
Tonya M Otto, APRN,CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4110 51st Ave S, Fargo, ND 58104 Phone: 701-364-3100  | |
Mary Omer Habib, APRN, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4622 40th Ave S Ste A, Fargo, ND 58104 Phone: 218-364-8900  | |
Mr. Nicholas Henry Frederiksen, APRN,CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3000 32nd Ave S, Fargo, ND 58103 Phone: 701-364-8000 Fax: 701-364-8078  |