Provider Demographics
NPI:1982882247
Name:JMD PSYCHIATRIC NURSING SERVICES, INC.
Entity Type:Organization
Organization Name:JMD PSYCHIATRIC NURSING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP, CNS
Authorized Official - Phone:218-751-0887
Mailing Address - Street 1:1526 30TH ST NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-4133
Mailing Address - Country:US
Mailing Address - Phone:218-751-0887
Mailing Address - Fax:218-759-4807
Practice Address - Street 1:1526 30TH ST NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-4133
Practice Address - Country:US
Practice Address - Phone:218-751-0887
Practice Address - Fax:218-759-4807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR077777-3261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health