Individual provider Active NPI

Kayla Nichole Maliske

  • Certified Registered Nurse Anesthetist
  • Fargo, ND
National Provider Identifier
1669386009
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
205851 Issued in ND
Practice address
5225 23Rd Ave S
Fargo, ND 58104-7927
Phone
(701) 648-9716
NPI assigned
Oct 1, 2026
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 205851 ND Primary

Addresses

Primary practice location

5225 23Rd Ave S
Fargo, ND 58104-7927

Mailing address

6428 21St St S
Fargo, ND 58104-7208
Phone (701) 648-9716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1669386009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6428 21ST ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047208",
            "telephone_number": "701-648-9716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 23RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047927",
            "telephone_number": "701-648-9716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALISKE",
        "first_name": "KAYLA",
        "middle_name": "NICHOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ND",
            "license": "205851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.