Individual
JILLIAN NICOLE FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT,ATC
Contact information
Practice address
1025 N 2ND ST, BISMARCK, ND 58501-3536
(636) 352-7983
Mailing address
1531 SHARLOH LOOP, BISMARCK, ND 58501-7700
(636) 352-7983
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
809-18
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
809-18
NORTH DAKOTA BOARD OF ATHLETIC TRAINERS
ND
Enumeration date
06/07/2019
Last updated
06/07/2019
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