Individual
JAKIANN MARIE MORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 982-7893
Mailing address
4535 HEIGHTS DR, COLUMBIA HEIGHTS, MN 55421-3321
(763) 571-8105
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R103401-7
MN
Other
Enumeration date
08/03/2009
Last updated
08/03/2009
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