Julianne Legierse, CPNP-PC
Individual provider Active NPI Pediatric Nurse Practitioner · Minot Afb, ND
NPI 1821609488 · NPPES record last updated Jun 25, 2023
Key facts
- NPI
- 1821609488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 0024179913 (VA)
- Practice address
- 10 Missle Ave 5TH Medical Group
Minot Afb, ND 58405-2040 - Phone
- (701) 723-5633
- NPI assigned
- Aug 16, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024179913 | VA | MD | Pediatric Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 0024179913 | VA | Yes |
Addresses
Primary practice location
10 Missle Ave 5TH Medical Group
Minot Afb, ND 58405-2040
Mailing address
10 Missile Ave
Minot Afb, ND 58705-5003
Phone (701) 723-5663
Other names
- Julianne Clemons
Other providers in Minot Afb, ND
- James W Koll
- Lisa Krogman
- Zsuzsanna Danuta Krokovay
- Andrea Marie Larocque
- Soo Young Lee
- Agnes Liem
- Robert B Long
- Shianne M Lundy
- Samuel Madden
- Kerri Beth Carson Mannion
All providers in Minot Afb, ND · Pediatric 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 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.