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Individual

JEFFERY D STOCKWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N.P.

Contact information

Practice address
2615 FAIRWAY ST, DICKINSON, ND 58601-2590
(701) 456-6000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
25328
MT
363LF0000X
Family Nurse Practitioner
Primary
R27770
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
19836
ND
01
370061
BLUE CROSS/BLUE SHIELD MT
MT
01
370061
FEDERAL BLUE CROSS
05
4307550
MT
01
P00298214
MEDICARE RAIL ROAD
Enumeration date
09/25/2006
Last updated
04/15/2026
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