| Kellie Weisenburger, FNP | |
|
87 Lincoln Ave, Underwood, ND 58576 | |
| (701) 442-3148 | |
| (701) 442-3414 |
| Full Name | Kellie Weisenburger |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 27 Years |
| Location | 87 Lincoln Ave, Underwood, North Dakota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134118748 | NPI | - | NPPES |
| 025563 | Other | ND | BCBS |
| 19789 | Medicaid | ND | |
| A63211044293 | Other | PREFERRED ONE | |
| 007 | Other | AMERICA'S PPO | |
| 025564 | Other | ND | BCBS |
| P00300571 | Other | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R25051 (North Dakota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sanford Medical Center Bismarck | Bismarck, ND | Hospital |
| Chi St Alexius Health Turtle Lake | Turtle lake, ND | Hospital |
| Sakakawea Medical Center - Cah | Hazen, ND | Hospital |
| Chi St Alexius Health | Bismarck, ND | Hospital |
| Garrison Memorial Hospital | Garrison, ND | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Underwood Clinic Pc | 3678486156 | 3 |
| Entity Name | Underwood Clinic Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770591927 PECOS PAC ID: 3678486156 Enrollment ID: O20031111000406 |
| Mailing Address | Practice Location Address |
|---|---|
| Kellie Weisenburger, FNP Po Box 253, Underwood, ND 58576-0253 Ph: (701) 442-3148 | Kellie Weisenburger, FNP 87 Lincoln Ave, Underwood, ND 58576 Ph: (701) 442-3148 |
Michele Leidholm, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 87 Lincoln Ave, Underwood, ND 58576 Phone: 701-442-3148 Fax: 701-442-3414 |