| Willow Health, Pllc | |
|
4133 30th Ave S Ste 103 Fargo ND 58104-8421 | |
| (701) 658-5577 | |
| (701) 888-5595 |
| Full Name | Willow Health, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4133 30th Ave S Ste 103, Fargo, North Dakota |
| Authorized Official Name and Position | Jessie Samantha Lindemann (PRESIDENT) |
| Authorized Official Contact | 6084452692 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Health, Pllc 4133 30th Ave S Ste 103 Fargo ND 58104-8421 Ph: (701) 658-5577 | Willow Health, Pllc 4133 30th Ave S Ste 103 Fargo ND 58104-8421 Ph: (701) 658-5577 |
| NPI Number | 1780426643 |
|---|---|
| Provider Enumeration Date | 06/11/2024 |
| Last Update Date | 12/30/2024 |
| Medicare PECOS PAC ID | 0547794224 |
|---|---|
| Medicare Enrollment ID | O20241118002355 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780426643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jessie S Lindemann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427492677 PECOS PAC ID: 0042520199 Enrollment ID: I20161003001658 |
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