Individual
JAMIE LYNN MISCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2624 9TH AVE S, FARGO, ND 58103
(701) 298-4500
(701) 298-4400
Mailing address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 298-4500
(701) 298-4400
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
247200000X
Other Technician
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1459270
—
ND
Enumeration date
08/01/2013
Last updated
09/08/2020
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