Individual
JACEY DECOTEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1058 COLLEGE DR, NEW TOWN, ND 58763-9112
(701) 627-4750
Mailing address
1058 COLLEGE DR, NEW TOWN, ND 58763-9112
(701) 627-4750
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R50056
ND
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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