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General NPI Number Information
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NPI Number | 1548572688
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Entity Type | Individual
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Provider Name | LORI JO ESPRIT M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 1000 SOUTH COLUMBIA ROAD
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City | GRAND FORKS
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State | ND
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Zip | 58206-6002
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Country | US
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Telephone | 701-780-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6002
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City | GRAND FORKS
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State | ND
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Zip | 58206-6002
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Country | US
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Telephone | 701-780-5000
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 11209
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License Number State | ND
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