Provider Demographics
NPI:1558049619
Name:STROMME, JADIN TAYLOR (APRN)
Entity Type:Individual
Prefix:
First Name:JADIN
Middle Name:TAYLOR
Last Name:STROMME
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JADIN
Other - Middle Name:TAYLOR
Other - Last Name:HEIDRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 HOLIDAY DR STE 170
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-4400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 HOLIDAY DR STE 170
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-4400
Practice Address - Country:US
Practice Address - Phone:218-293-4221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR445832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry