Individual
JESSICA A BALVITSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
414 N 7TH ST, BISMARCK, ND 58501-4423
(701) 323-6549
(701) 323-5492
Mailing address
PO BOX 5501, BISMARCK, ND 58506-5501
(701) 323-6000
(701) 323-5709
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R25536
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19603
—
ND
Enumeration date
09/15/2006
Last updated
01/11/2011
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