| Legacy Health Clinic | |
|
1324 20th Ave Sw Minot ND 58701-6452 | |
| (701) 720-0737 | |
| Not Available |
| Full Name | Legacy Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1324 20th Ave Sw, Minot, North Dakota |
| Authorized Official Name and Position | Cimberly Berg-hooker (OWNER/FOUNDER) |
| Authorized Official Contact | 7017200737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Health Clinic 2033 Lakeside St Minot ND 58703-0894 Ph: () - | Legacy Health Clinic 1324 20th Ave Sw Minot ND 58701-6452 Ph: (701) 720-0737 |
| NPI Number | 1598340358 |
|---|---|
| Provider Enumeration Date | 03/13/2021 |
| Last Update Date | 03/13/2021 |
| Medicare PECOS PAC ID | 7810391828 |
|---|---|
| Medicare Enrollment ID | O20210812000412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598340358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Janet L Maxson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851462014 PECOS PAC ID: 9335043884 Enrollment ID: I20070523000742 |
| Provider Name | Georgia R Krein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114205978 PECOS PAC ID: 8224209325 Enrollment ID: I20110921000652 |
| Provider Name | Cimberly Faye Berg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497224224 PECOS PAC ID: 4385977172 Enrollment ID: I20190611000331 |
| Provider Name | Stacy Nicole Flaten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063171122 PECOS PAC ID: 9436541935 Enrollment ID: I20220112002914 |
| Provider Name | Libby Hadan Aberle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609534809 PECOS PAC ID: 3577949353 Enrollment ID: I20220930002847 |
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