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General NPI Number Information
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NPI Number | 1902471634
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Entity Type | Individual
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Provider Name | JOURDON QUINN JAYE WICHMAN APRN-CNM
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Gender | Female
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 09/21/2024
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Provider Practice Location Address
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Address Line | PO BOX 81
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City | WINIFRED
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State | MT
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Zip | 59489-0081
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Country | US
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Telephone | 406-390-1276
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Fax | 800-853-6531
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Provider Business Mailing Address
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Address Line | PO BOX 81
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City | WINIFRED
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State | MT
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Zip | 59489-0081
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Country | US
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Telephone | 406-390-1276
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Fax | 800-853-6531
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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 | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | NUR-RN-LIC-70073
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | NUR-APRN-LIC-176408
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License Number State | MT
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