Provider Demographics
NPI:1952969099
Name:UNIVERSITY OF NORTH DAKOTA
Entity Type:Organization
Organization Name:UNIVERSITY OF NORTH DAKOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECALIST
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-777-3691
Mailing Address - Street 1:501 N COLUMBIA RD STOP 7132
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-2817
Mailing Address - Country:US
Mailing Address - Phone:701-777-3745
Mailing Address - Fax:
Practice Address - Street 1:501 N COLUMBIA RD STOP 7132
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-2817
Practice Address - Country:US
Practice Address - Phone:701-777-3745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF NORTH DAKOTA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-04
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty