Healthcare Provider Details

I. General information

NPI: 1255825253
Provider Name (Legal Business Name): JODI LYNN SHERVE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S COLUMBIA RD
GRAND FORKS ND
58201-4036
US

IV. Provider business mailing address

2527 GLEN CIR
GRAND FORKS ND
58201-5189
US

V. Phone/Fax

Practice location:
  • Phone: 701-780-5000
  • Fax: 701-780-4477
Mailing address:
  • Phone: 701-330-1784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR32643
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: