Individual ProviderLynn E NellermoeNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address737 Broadway, Fargo, ND 58122-0001(701) 234-6258PECOS EnrollmentBased on the most recent information from CMS, provider Lynn E Nellermoe does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:59 PM.Profile DetailsProvider ID1164449609Provider TypeIndividualFull NameNellermoe, Lynn ECredentialCRNAGenderMaleSole ProprietorNoEnumeration Date7/17/2006Last Updated9/15/2008Contact InformationPractice LocationPractice Address737 Broadway, Fargo, ND 58122-0001Phone(701) 234-6258Fax(701) 234-2345Mailing LocationMailing Address737 Broadway, Fargo, ND 58122-0001Phone(701) 234-6258Fax(701) 234-2345Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR14419North Dakota