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Individual

JERANE A FORSBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1500 24TH AVE SW, MINOT, ND 58701-6905
(701) 857-5150
(701) 857-5564
Mailing address
PO BOX 5010, MINOT, ND 58702-5010
(701) 418-8000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0225
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18261
ND
Enumeration date
10/16/2006
Last updated
12/22/2023
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