Provider Demographics
NPI:1235161670
Name:RUGG, JENNIFER TVEIT (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:TVEIT
Last Name:RUGG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6001
Mailing Address - Country:US
Mailing Address - Phone:701-364-3300
Mailing Address - Fax:701-364-8906
Practice Address - Street 1:1702 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4940
Practice Address - Country:US
Practice Address - Phone:701-364-3300
Practice Address - Fax:701-364-8906
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2015-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6894225100000X
ND1249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN22471OtherNDBS #
MNDA9021015523OtherPREFERRED ONE #
MN1696876OtherAMERICA'S PPO/ARAZ #
MN262J9TVOtherMNBS #
MN6403542OtherMEDICA #
MNHP38642OtherHEALTHPARTNERS #
MNDA9021015523OtherPREFERRED ONE #
MN650000892Medicare ID - Type UnspecifiedMN MEDICARE #