Larae Marie Storer, APRN, FNP
Individual provider Active NPI Family Nurse Practitioner · Fargo, ND
NPI 1376285262 · NPPES record last updated Jun 2, 2022
Key facts
- NPI
- 1376285262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R33706 (ND)
- Practice address
- 1112 Nodak Dr S
Fargo, ND 58103-2333 - Phone
- (701) 232-6224
- Fax
- (701) 232-4687
- NPI assigned
- Apr 11, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220614001560 | ND | Practitioner - Nurse Practitioner | 3072992528 |
Reassigns benefits to 1 organization Practice locations: Aneta, ND |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A167681 | IA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restorer Health PLLC | Family | Current |
Accepting new patients |
| Ashley Kasson Therapy PLLC | Current |
Accepting new patients |
Locations
3220 4th St E
Ste 102
West Fargo, ND 58078
Phone (701) 501-7449
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A167681 | IA | |
| Family Nurse Practitioner | 363LF0000X | R33706 | ND | Yes |
Addresses
Primary practice location
1112 Nodak Dr S
Fargo, ND 58103-2333
Mailing address
1112 Nodak Dr S
Fargo, ND 58103-2333
Phone (701) 232-6224
Other providers in Fargo, ND
- Stacy J Stoner-Dockter
- Caitlyn Claire Stonestreet
- Sarah Stoops
- Anna Stoppleworth
- Harrison F. Storandt
- Alaina Elizabeth Storey
- Jade Storley
- Waldemar G Storm
- Bailey S Stotts
- Rachel Lynn Stotts
All providers in Fargo, ND · Family Nurse Practitioner in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.