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General NPI Number Information
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NPI Number | 1184694127
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Entity Type | Individual
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Provider Name | MICHELLE JOY FUNDINGSLAND RD
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Gender | Female
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 400 BURDICK EXPY E FL 1
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City | MINOT
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State | ND
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Zip | 58701-4768
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Country | US
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Telephone | 701-857-2850
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Fax | 701-857-5593
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Provider Business Mailing Address
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Address Line | PO BOX 5010
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City | MINOT
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State | ND
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Zip | 58702-5010
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Country | US
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Telephone | 701-857-2850
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Fax | 701-857-5593
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 678
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License Number State | ND
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