Provider Demographics
NPI:1235325549
Name:ZINK, JAMIE LYN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LYN
Last Name:ZINK
Suffix:
Gender:F
Credentials:PA-C
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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:701-364-5751
Mailing Address - Fax:701-364-5722
Practice Address - Street 1:1401 13TH AVE E
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3468
Practice Address - Country:US
Practice Address - Phone:701-364-5751
Practice Address - Fax:701-364-5722
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2015-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NDPAC0493363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILQ29946Medicare UPIN