Healthcare Provider Details

I. General information

NPI: 1275866824
Provider Name (Legal Business Name): JESSICA L AHMANN DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2009
Last Update Date: 04/02/2020
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N 9TH ST
BISMARCK ND
58501-4530
US

IV. Provider business mailing address

401 N 9TH ST
BISMARCK ND
58501-4506
US

V. Phone/Fax

Practice location:
  • Phone: 701-712-4902
  • Fax: 701-712-4174
Mailing address:
  • Phone: 701-712-4548
  • Fax: 701-712-4174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR29645
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR29645
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: