Provider Demographics
NPI:1356006886
Name:KRINKE, JAMIE LYNN
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:KRINKE
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 1:10104 132ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:ND
Mailing Address - Zip Code:58653-9292
Mailing Address - Country:US
Mailing Address - Phone:701-206-1148
Mailing Address - Fax:
Practice Address - Street 1:10104 132ND AVE SW
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:ND
Practice Address - Zip Code:58653-9292
Practice Address - Country:US
Practice Address - Phone:701-206-1148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-31
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant