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General NPI Number Information
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NPI Number | 1306134309
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Entity Type | Individual
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Provider Name | JAIME RAE MATTSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 1319 W 11TH ST
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City | GRAFTON
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State | ND
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Zip | 58237-2138
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Country | US
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Telephone | 701-352-4059
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Fax | 701-352-9290
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Provider Business Mailing Address
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Address Line | 1458 WESTERN AVE
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City | GRAFTON
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State | ND
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Zip | 58237-1879
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Country | US
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Telephone | 701-360-0697
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R30910
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License Number State | ND
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