Individual
JENNIFER S GOETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LRD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 312-9802
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
685
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272447000
—
MN
05
—
51118
—
ND
Enumeration date
05/30/2006
Last updated
08/24/2023
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