Individual
PAMELA J JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA RN PMHNP
Contact information
Practice address
624 S 13TH ST, RANGE MENTAL HEALTH CENTER INC, VIRGINIA, MN 55792
(218) 749-2881
(218) 749-3806
Mailing address
624 S 13TH ST, RANGE MENTAL HEALTH CENTER INC, VIRGINIA, MN 55792
(218) 749-2881
(218) 749-3806
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R1503137
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
524131600
—
MN
Enumeration date
09/26/2006
Last updated
07/24/2012
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