Active NPI
Jenna Noland, MS, ATC
- Athletic Trainer
- West Fargo, ND
National Provider Identifier
1356664213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2158
- Practice address
- 4526 12TH St W
West Fargo, ND 58078-8830 - Phone
- (218) 779-9391
- NPI assigned
- Mar 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2158 | MN | Primary |
Addresses
Primary practice location
4526 12TH St W
West Fargo, ND 58078-8830
Mailing address
4526 12TH St W
West Fargo, ND 58078-8830
Phone (218) 779-9391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2158 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268006400000",
"number": "1356664213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4526 12TH ST W",
"city": "WEST FARGO",
"state": "ND",
"postal_code": "580788830",
"telephone_number": "218-779-9391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4526 12TH ST W",
"city": "WEST FARGO",
"state": "ND",
"postal_code": "580788830",
"telephone_number": "218-779-9391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAND",
"first_name": "JENNA",
"credential": "MS, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-08",
"last_updated": "2010-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "2158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.