Individual
JERI ANN AZURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
9775 BIA ROAD 9 FL 2, BELCOURT, ND 58316-2807
(701) 477-0483
(701) 477-0488
Mailing address
PO BOX 1149, BELCOURT, ND 58316-1149
(701) 477-0483
(701) 477-0488
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
486
ND
103TC0700X
Clinical Psychologist
Primary
486
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01063
—
ND
05
—
1452221
—
ND
01
—
350063
MEDICARE ID-TYPE UNSPECIFIED
ND
Enumeration date
05/26/2010
Last updated
04/17/2026
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