Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 67130 | MN |
NPI | 1013204882 |
---|---|
Provider Name | Jennifer Jue |
First Address | Fargo, ND 58103-4940 |
Second Address | Brainerd, MN 56401-4529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 16/07/2020 |