Provider Demographics
NPI:1407685415
Name:NORTH DAKOTA CENTER FOR WEIGHT MANAGEMENT, PLLC
Entity type:Organization
Organization Name:NORTH DAKOTA CENTER FOR WEIGHT MANAGEMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:FALEIDE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C
Authorized Official - Phone:701-807-0684
Mailing Address - Street 1:14887 FORK ST
Mailing Address - Street 2:
Mailing Address - City:WHEATLAND
Mailing Address - State:ND
Mailing Address - Zip Code:58079-4305
Mailing Address - Country:US
Mailing Address - Phone:701-807-0684
Mailing Address - Fax:833-605-4039
Practice Address - Street 1:320 32ND AVE W STE 285
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8372
Practice Address - Country:US
Practice Address - Phone:701-807-0684
Practice Address - Fax:833-605-4039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty