Individual
JESSICA R THEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2101 ELM STREET N, FARGO, ND 58102
(701) 239-3700
(218) 335-3352
Mailing address
2101 ELM STREET N, FARGO, ND 58102
(701) 239-3700
(218) 335-3352
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
122351
MN
183500000X
Pharmacist
Primary
RPH5786
ND
Other
Enumeration date
04/06/2017
Last updated
06/20/2025
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