Jumping Eagle, Sara Juanita

Jumping Eagle, Sara Juanita is an individual health care provider with primary practice located at 10 N. River Rd. Fort Yates Ihs Hospital/Clinic, Ft. Yates ND 58538. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Jumping Eagle, Sara Juanita can be contacted via phone (701) 854-3831.

Contact Information

Primary practice address
10 N. River Rd. Fort Yates Ihs Hospital/Clinic Ft. Yates ND 58538
Phone: (701) 854-3831
Fax: (701) 854-7399
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 11019 North Dakota

Profile Details

NPI number 1508865007
LBN Legal business name Jumping Eagle, Sara Juanita
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Dec 3rd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508865007 NPPES
North Dakota MEDICAID 15044

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