Individual ProviderMelissa VanmatreNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address737 Broadway, Fargo, ND 58122-0001(701) 234-6258(701) 234-1261PECOS EnrollmentBased on the most recent information from CMS, provider Melissa Vanmatre 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 ID1588974596Provider TypeIndividualFull NameVanmatre, MelissaCredentialCRNAGenderFemaleSole ProprietorNoEnumeration Date10/13/2010Last Updated5/17/2011Contact InformationPractice LocationPractice Address737 Broadway, Fargo, ND 58122-0001Phone(701) 234-6258FaxUnlisted FaxMailing LocationMailing AddressPO Box Mc, Fargo, ND 58122-0605Phone(701) 234-1261FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR29312North DakotaProvider IdentifiersIDDescriptionIssuerID15674DescriptionMedicaidIssuerUnlistedNorth Dakota