Healthcare Provider Details

I. General information

NPI: 1154851244
Provider Name (Legal Business Name): JENNA LEIGH THOMPSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 HIGHWAY 2 E
RUGBY ND
58368-7801
US

IV. Provider business mailing address

2975 HIGHWAY 2 E
RUGBY ND
58368-7801
US

V. Phone/Fax

Practice location:
  • Phone: 701-776-5235
  • Fax:
Mailing address:
  • Phone: 701-776-5235
  • Fax: 701-776-5297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR34020
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: