Individual
JENNA B MAZOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,CNP
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 844-2347
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(715) 483-0507
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4772
MN
363LF0000X
Family Nurse Practitioner
7019
WI
Other
Enumeration date
06/22/2016
Last updated
04/09/2024
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