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Individual

TYLER JORGENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-2575
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R47791
ND
367500000X
Certified Registered Nurse Anesthetist
Primary
203411
ND

Other

Enumeration date
07/10/2023
Last updated
10/10/2025
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