Witte-Bakken, Jan Karen

Witte-Bakken, Jan Karen is an individual health care provider with primary practice located at 891 Belsly Blvd , Moorhead MN 56560-5055. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Witte-Bakken, Jan Karen can be contacted via phone (218) 287-4338.

Contact Information

Primary practice address
891 Belsly Blvd Moorhead MN 56560-5055
Phone: (218) 287-4338
Fax: (218) 287-5928
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2205 Minnesota
Behavioral Health & Social Service Providers / Clinical 103TC0700X 306 North Dakota

Profile Details

NPI number 1013001114
LBN Legal business name Witte-Bakken, Jan Karen
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Feb 24th, 2017 - about 9 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 1013001114 NPPES
North Dakota Other 18691 BLUE CROSS
North Dakota Other 11082 BLUE CROSS
North Dakota MEDICAID 505252100 BLUE CROSS

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