Individual
JENNA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
417 MAIN AVE STE 401, FARGO, ND 58103-1956
(701) 289-7676
Mailing address
417 MAIN AVE STE 401, FARGO, ND 58103-1956
(701) 289-7676
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
ND
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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