| Traci Specht, | |
|
2100 S Columbia Rd Ste 114, Grand Forks, ND 58201-5895 | |
| (701) 516-4637 | |
| (877) 651-1381 |
| Full Name | Traci Specht |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 2100 S Columbia Rd Ste 114, Grand Forks, 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 |
|---|---|---|---|
| 1144908625 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R31830 (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 |
|---|---|
| Traci Specht, Po Box 13238, Grand Forks, ND 58208-3238 Ph: (701) 516-4637 | Traci Specht, 2100 S Columbia Rd Ste 114, Grand Forks, ND 58201-5895 Ph: (701) 516-4637 |
Ms. Estella Ann Boger, GNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1000 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-780-5000 | |
Bethann Marie Nuelle, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4700 S Washington St, Grand Forks, ND 58201 Phone: 701-757-2559 | |
Kaitlyn Rose Vagle, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1200 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-780-5000 | |
Ms. Mary Pat Holler-bibel, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 718 Oak St, Grand Forks, ND 58201 Phone: 218-230-0070 Fax: 800-958-7702 | |
Kayla Clausen, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 960 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-780-5400 Fax: 701-780-6416 | |
Kelsey Vivatson, PMHNP-BC, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2534 17th Ave S Ste E, Grand Forks, ND 58201 Phone: 701-885-4551 Fax: 701-757-1351 | |
Laura Olson, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1300 S Columbia Rd, Grand Forks, ND 58201 Phone: 701-780-2300 Fax: 701-780-6940 |