Individual
MCKENZIE JADE ULMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 WESTRAC DR S, FARGO, ND 58103-2338
(701) 365-1776
Mailing address
1202 WESTRAC DR S, FARGO, ND 58103-2338
(701) 365-1776
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X
ND
174400000X
Specialist
—
—
Other
Enumeration date
06/29/2023
Last updated
02/15/2024
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