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Individual

JANE OSTLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
600 1ST ST SE, MAYVILLE, ND 58257-1518
(701) 788-4500
(701) 788-4500
Mailing address
600 1ST ST SE, MAYVILLE, ND 58257-1518
(701) 788-4500
(701) 788-4500

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11491
ND
207Q00000X
Family Medicine Physician
TRL10930
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
15151
ND
Enumeration date
06/16/2008
Last updated
09/12/2011
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