Individual
JEAN M NYGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNFNP PAC
Contact information
Practice address
112 1ST AVE NW, CROSBY, ND 58730-0658
(701) 965-6349
Mailing address
PO BOX C, CROSBY, ND 58730
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R15464
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19648
—
ND
01
—
4702
NORTH DAKOTA BLUE SHIELD
ND
Enumeration date
07/16/2006
Last updated
10/22/2007
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