Individual
STEPHANIE JALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-7300
Mailing address
PO BOX 997, BISMARCK, ND 58502-0997
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
13695
ND
2084P0804X
Child & Adolescent Psychiatry Physician
ME116874
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81891
—
ND
Enumeration date
06/29/2010
Last updated
09/11/2015
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