Individual
JACQUELINE MARIE GRUNEFELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNPC
Contact information
Practice address
511 ELM AVE, LINTON MEDICAL CENTER, LINTON, ND 58552
(701) 254-4531
(701) 254-5459
Mailing address
1955 HWY 34, KINTYRE, ND 58549
(701) 332-6314
(701) 254-5459
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R26709
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19814
—
ND
01
—
26435
BCBS
ND
Enumeration date
07/15/2006
Last updated
10/16/2020
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