Provider Demographics
NPI:1538699566
Name:STEELE, JENNY (FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:STEELE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 28TH ST S APT 207
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8867
Mailing Address - Country:US
Mailing Address - Phone:701-471-5695
Mailing Address - Fax:
Practice Address - Street 1:3955 56TH ST S STE D
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4845
Practice Address - Country:US
Practice Address - Phone:701-234-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR33356207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine