Jenna Medina
Individual provider Active NPI Case Manager/Care Coordinator · Fargo, ND
NPI 1245042365 · NPPES record last updated Jan 24, 2025
Key facts
- NPI
- 1245042365
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 417 Main Ave Ste 401
Fargo, ND 58103-1956 - Phone
- (701) 289-7676
- NPI assigned
- Jan 24, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocates for Change | Current |
Accepting new patients | |
| Community Uplift Program | Current |
Accepting new patients |
Locations
417 Main Ave
Ste 401
Fargo, ND 58103
Phone (701) 289-7676
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | ND | Yes |
Addresses
Primary practice location
417 Main Ave Ste 401
Fargo, ND 58103-1956
Mailing address
417 Main Ave Ste 401
Fargo, ND 58103-1956
Phone (701) 289-7676
Other providers in Fargo, ND
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- Stacie Medenwald
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- Medstar Transportation LLC
- Samantha Meech
- Emily Jane Meester
- John B Mehlhoff
All providers in Fargo, ND · Case Manager/Care Coordinator in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.