Gagner-Tjellesen, Desiree Joanne

Gagner-Tjellesen, Desiree Joanne is an individual health care provider with primary practice located at 151 S 4Th St Suite 401, Grand Forks ND 58201-4715. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist, which is considered as her primary health care specialty. Gagner-Tjellesen, Desiree Joanne can be contacted via phone (701) 795-3000.

Contact Information

Primary practice address
151 S 4Th St Suite 401 Grand Forks ND 58201-4715
Phone: (701) 795-3000
Fax: (701) 795-3050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist 364S00000X R24745 North Dakota

Profile Details

NPI number 1518906437
LBN Legal business name Gagner-Tjellesen, Desiree Joanne
Credentials RNCS,APRN,BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518906437 NPPES
Minnesota Other 638R1GA BCBS MN PROVIDER NUMBER
Minnesota Other 020043 BCBS MN PROVIDER NUMBER
Minnesota MEDICAID 054519 BCBS MN PROVIDER NUMBER

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