Individual
JUDITH L REESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4656 40TH AVE S, FARGO, ND 58104-4397
(701) 234-8860
(701) 234-8924
Mailing address
4656 40TH AVE S, FARGO, ND 58104-4397
(701) 234-8860
(701) 234-8924
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
PAC0352
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71075
—
ND
Enumeration date
07/16/2006
Last updated
10/17/2012
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