Individual
JACK T BADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NPC
Contact information
Practice address
4110 51ST AVENUE SOUTH, FARGO, ND 58104
(701) 364-3100
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R34830
ND
Other
Enumeration date
07/15/2016
Last updated
09/07/2016
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