Provider Demographics
NPI:1710561329
Name:JOBLINSKI, KEELY ANN
Entity Type:Individual
Prefix:
First Name:KEELY
Middle Name:ANN
Last Name:JOBLINSKI
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 1:3260 RIVER PLACE DR N
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-8225
Mailing Address - Country:US
Mailing Address - Phone:701-400-6793
Mailing Address - Fax:
Practice Address - Street 1:3260 RIVER PLACE DR N
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-8225
Practice Address - Country:US
Practice Address - Phone:701-400-6793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care