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General NPI Number Information
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NPI Number | 1619264942
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Entity Type | Individual
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Provider Name | JENNIFER ANN FRAIK FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 1500 BIRCHMONT DR NE # 42
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City | BEMIDJI
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State | MN
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Zip | 56601-2699
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Country | US
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Telephone | 218-755-2871
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Fax | 218-755-2750
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Provider Business Mailing Address
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Address Line | 2324 FROHN RD NE
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City | BEMIDJI
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State | MN
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Zip | 56601-7405
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Country | US
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Telephone | 218-556-3009
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R1649965
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License Number State | MN
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