Individual
MARJORIE K TRIEBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
401 3RD ST SE, JAMESTOWN, ND 58401-4247
(701) 253-5300
(701) 253-5402
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 253-5300
(701) 253-5402
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0188
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0111506
MEDICA #
ND
01
—
142353
UCARE #
ND
01
—
31Q26TR
MNBS #
ND
05
—
540698600
—
ND
01
—
DA9061015526
PREFERRED ONE #
ND
01
—
HP38589
HEALTHPARTNERS #
ND
Enumeration date
05/23/2006
Last updated
05/23/2012
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