Healthcare Provider Details

I. General information

NPI: 1336067966
Provider Name (Legal Business Name): JAYDEN MARIE LINDGREN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 BROADWAY N APT 305
FARGO ND
58102-4646
US

IV. Provider business mailing address

405 BROADWAY N APT 305
FARGO ND
58102-4646
US

V. Phone/Fax

Practice location:
  • Phone: 701-809-8232
  • Fax:
Mailing address:
  • Phone: 701-809-8232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: