Healthcare Provider Details

I. General information

NPI: 1841264892
Provider Name (Legal Business Name): KRISTINA ENGLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINA JENSEN M.D.

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 11TH ST S
WAHPETON ND
58075-4655
US

IV. Provider business mailing address

1702 UNIVERSITY DR S
FARGO ND
58103-4940
US

V. Phone/Fax

Practice location:
  • Phone: 701-642-2000
  • Fax: 701-671-4106
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberPT15336
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: