Provider Demographics
NPI:1356786701
Name:ESLINGER, JEROME CLARENCE
Entity type:Individual
Prefix:
First Name:JEROME
Middle Name:CLARENCE
Last Name:ESLINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 25TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-8724
Mailing Address - Country:US
Mailing Address - Phone:701-237-9977
Mailing Address - Fax:
Practice Address - Street 1:825 25TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-8724
Practice Address - Country:US
Practice Address - Phone:701-237-9977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDH-0009237700000X
MN2469237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist