Provider Demographics
NPI:1174281489
Name:PLECITY, JODI
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:PLECITY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4779 63RD ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4502
Mailing Address - Country:US
Mailing Address - Phone:701-541-0875
Mailing Address - Fax:
Practice Address - Street 1:4779 63RD ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4502
Practice Address - Country:US
Practice Address - Phone:701-541-0875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No172V00000XOther Service ProvidersCommunity Health Worker
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner