Individual
SARA JUANITA JUMPING EAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10 N. RIVER RD., FORT YATES IHS HOSPITAL/CLINIC, FT. YATES, ND 58538
(701) 854-3831
(701) 854-7399
Mailing address
10 NORTH RIVER ROAD, FORT YATES, ND 58538
(701) 854-3831
(701) 854-7399
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
11019
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15044
—
ND
Enumeration date
07/18/2005
Last updated
12/03/2014
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