MEDICARE: JESSIE LINDEMANN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	14193	ND

General Provider Information

NPI Number	:	1427492677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSIE LINDEMANN MD

Provider Business Mailing Address
First Line	:	1100 19TH AVE N STE J-142
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-5906
Country	:	US
Telephone Number	:	701-658-5577
Fax Number	:	701-888-5595

Provider Business Practice Location Address
First Line	:	4133 30TH AVE S STE 103
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58104-8421
Country	:	US
Telephone Number	:	701-658-5577
Fax Number	:	701-888-5595

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2013
Last Update Date	:	07/02/2025

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