Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. McKenzie Ann Disrud, FNP

Individual provider Surgical Physician Assistant · NPI 1265093124

Mrs. McKenzie Ann Disrud, FNP is a Nurse Practitioner in Grand Forks, North Dakota. Graduated from University of North Dakota School of Medicine in 2019, 7 years ago. Practices with Legacy Medical LLC, a 20-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Dakota.

Years since qualifying
7
Trained at
University of North Dakota School of Medicine
Licensed in
ND
In the registry since
2019
Specialties on file
3
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

See every abbreviation used in this directory →

Practice location Address checks out

2100 S Columbia Rd Ste 114
Grand Forks, ND 58201-5895
Phone: (701) 516-4637
Fax: (877) 651-1381
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RH1306 (ND)
Surgical Physician Assistant Taxonomy 363AS0400X
Family Nurse Practitioner Taxonomy 363LF0000X · Licence F06191893 (ND)

Record details

NPI number1265093124
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedJune 21, 2019
Last updated in NPPESJanuary 30, 2025
Certification dateJanuary 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice Legacy Medical Llc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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