| Michelle Jill Rexine, | |
|
4420 37th Ave S # 1, Fargo, ND 58104-3400 | |
| (701) 516-4637 | |
| Not Available |
| Full Name | Michelle Jill Rexine |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 4 Years |
| Location | 4420 37th Ave S # 1, Fargo, 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 |
|---|---|---|---|
| 1598413312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | R31653 (North Dakota) | Secondary |
| 363L00000X | Nurse Practitioner | R31653 (North Dakota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hospice Of Red River Valley | Fargo, ND | Hospice |
| Sanford Medical Center Fargo | Fargo, ND | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Legacy Medical Llc | 0648698290 | 20 |
| Legacy Primary Care Pllc | 5799223491 | 16 |
| 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 | Provider Partners Care Management Lp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013348028 PECOS PAC ID: 9335379270 Enrollment ID: O20240503001124 |
| 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 |
|---|---|
| Michelle Jill Rexine, Po Box 13238, Grand Forks, ND 58208-3238 Ph: (701) 516-4637 | Michelle Jill Rexine, 4420 37th Ave S # 1, Fargo, ND 58104-3400 Ph: (701) 516-4637 |
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: Accepting Medicare Assignments 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: Accepting Medicare Assignments Practice Location: 4110 51st Ave S, Fargo, ND 58104 Phone: 701-364-3100 | |
Mary Omer Habib, APRN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4622 40th Ave S Ste A, Fargo, ND 58104 Phone: 218-364-8900 | |
Mr. Nicholas Henry Frederiksen, APRN,CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3000 32nd Ave S, Fargo, ND 58103 Phone: 701-364-8000 Fax: 701-364-8078 |