Individual
JENIFER WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, GNP-BC
Contact information
Practice address
3221 32ND AVE S STE 700, GRAND FORKS, ND 58201-6075
(701) 239-3700
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R-172391-7
MN
363LG0600X
Gerontology Nurse Practitioner
R31542
ND
Other
Enumeration date
11/06/2013
Last updated
03/19/2025
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