Provider Demographics
NPI:1891033049
Name:HOUGE, JENNA B (CRNA)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:B
Last Name:HOUGE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:B
Other - Last Name:KLABUNDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 5010
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-5010
Mailing Address - Country:US
Mailing Address - Phone:701-857-5650
Mailing Address - Fax:701-857-5031
Practice Address - Street 1:1 BURDICK EXPY W
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4406
Practice Address - Country:US
Practice Address - Phone:701-857-5124
Practice Address - Fax:701-857-3264
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR33351367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered