Individual
JOLEEN R HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
419 5TH ST NE, JAMESTOWN, ND 58401-3300
(701) 252-1050
(701) 952-3265
Mailing address
419 5TH ST NE, JAMESTOWN, ND 58401-3300
(701) 252-1050
(701) 952-3265
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
676
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26957
BLUE SHIELD
—
01
—
6300416
MEDICA
—
01
—
HP64722
HEALTH PARTNERS
—
01
—
P00411343
RR MEDICARE
—
Enumeration date
07/03/2006
Last updated
12/05/2007
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