Jennifer Bourne, LMT

Individual provider Active NPI Massage Therapist · Jamestown, ND

NPI 1962099879 · NPPES record last updated Dec 26, 2020

Key facts

NPI
1962099879
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
833 (ND)
Practice address
242 18TH Ave NE
Jamestown, ND 58401-3845
Phone
(701) 269-1975
NPI assigned
Dec 26, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 833 ND Yes

Addresses

Primary practice location

242 18TH Ave NE
Jamestown, ND 58401-3845

Mailing address

242 18TH Ave NE
Jamestown, ND 58401-3845
Phone (701) 269-1975

Other names

  • Jennifer Wimer Former name

Other providers in Jamestown, ND

All providers in Jamestown, ND · Massage Therapist in North Dakota

Sources for this page

Verify at the official NPI Registry.