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Individual

JEFFREY VANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-8000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R36482
ND

Other

Enumeration date
02/24/2016
Last updated
02/24/2016
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