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Individual

JORDAN JAMES REESE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
1295 BAY RIDGE DR, DETROIT LAKES, MN 56501
(218) 289-3107
Mailing address
1295 BAY RIDGE DR, DETROIT LAKES, MN 56501-4911
(218) 289-3107

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R2033172
MN
363LF0000X
Family Nurse Practitioner
Primary
2033172
MN
363LF0000X
Family Nurse Practitioner
41156
ND

Other

Enumeration date
05/17/2018
Last updated
04/29/2022
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