Individual
JANESSA LYNNE HEGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1300 S COLUMBIA RD, GRAND FORKS, ND 58201-4012
(701) 780-2300
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 741-9967
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
R30524
ND
363L00000X
Nurse Practitioner
Primary
R30524
ND
Other
Enumeration date
11/25/2020
Last updated
04/19/2022
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