Individual
JANE A GRORUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1213 15TH AVE W, WILLISTON, ND 58801-3800
(701) 572-7651
(701) 774-7479
Mailing address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7400
(701) 774-7479
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5994
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16461
—
ND
Enumeration date
07/20/2006
Last updated
12/20/2012
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