Individual
JAZMYN GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
39 3RD AVE NW, KILLDEER, ND 58640
(701) 590-8875
Mailing address
39 3RD AVE NW, PO BOX 775, KILLDEER, ND 58640
(701) 590-8875
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
1478813
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1478813
—
ND
Enumeration date
01/04/2021
Last updated
01/04/2021
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