Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 56719 | MN |
NPI | 1043453772 |
---|---|
Provider Name | Jolyn Seitz |
First Address | Fargo, ND 58107-2168 |
Second Address | Bemidji, MN 56601-5103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2009 |
Last Update Date | 07/03/2016 |