Individual
JEAN L GULLICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP
Contact information
Practice address
1112 NODAK DR S, FARGO, ND 58103-2333
(701) 232-6224
(701) 232-4687
Mailing address
1112 NODAK DR S, FARGO, ND 58103-2333
(701) 232-6224
(701) 232-4687
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R16783
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467682
—
ND
Enumeration date
06/27/2006
Last updated
01/24/2023
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