Healthcare Provider Details

I. General information

NPI: 1396670063
Provider Name (Legal Business Name): JASLEEN KAUR BAINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 N COLUMBIA RD STOP 9037
GRAND FORKS ND
58202-9037
US

IV. Provider business mailing address

1301 N COLUMBIA RD STOP 9037
GRAND FORKS ND
58202-9037
US

V. Phone/Fax

Practice location:
  • Phone: 701-777-3069
  • Fax:
Mailing address:
  • Phone: 701-777-3069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberRL24641
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: