Healthcare Provider Details

I. General information

NPI: 1164151882
Provider Name (Legal Business Name): J&N OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 4TH ST NE
EAST GRAND FORKS MN
56721-2407
US

IV. Provider business mailing address

PO BOX 12562
GRAND FORKS ND
58208-2562
US

V. Phone/Fax

Practice location:
  • Phone: 701-775-8294
  • Fax: 218-399-0174
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: BRIAN MARTIN
Title or Position: MANAGER
Credential:
Phone: 701-317-5338