Individual provider · Type 1 NPI

Jillene Marie Bantau

Specialist · Fergus Falls, MN

NPI number 1225528664 Active

Practice location

1806 E Fir Ave Ste 200
Fergus Falls, MN 56537-3921

Call (218) 998-2992 Map

Mailing address

891 Belsly Blvd
Moorhead, MN 56560-5055

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1225528664

Jillene Marie Bantau's National Provider Identifier is 1225528664, issued on May 10, 2018. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Fergus Falls, MN. The record was last updated on Aug 11, 2020.