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1770243727
JACOB KOHL PEDERSON
FARGO, ND
NPI
1770243727
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner Gerontology
(Licence: ND R51672)
Enumeration Date
2021-12-17
Last Update Date
2021-12-17
Business Address
MR. JACOB KOHL PEDERSON APRN CNP
3000 32ND AVE S
FARGO, ND 58103-6132
Phone number: 701-364-8000
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Mailing Address
MR. JACOB KOHL PEDERSON APRN CNP
400 E 3RD ST
DULUTH, MN 55805-1951
Phone number: 218-786-8364
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