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Jillene Marie Bantau
Specialist in Fergus Falls, Minnesota
NPI 1225528664

Jillene Marie Bantau is a Specialist based in Moorhead, MN. Jillene Marie Bantau practices in Fergus Falls, MN. The NPI Number for Jillene Marie Bantau is 1225528664 and holds a License No. (Minnesota).

The current practice location address for Jillene Marie Bantau is 1806 E Fir Ave Ste 200, Fergus Falls, MN and can be reached out via phone at 218-998-2992.

Location: 1806 E Fir Ave Ste 200, Fergus Falls, MN, 56560-5055
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225528664
Provider Name
Jillene Marie Bantau
Credential
Provider Entity Type
Individual
Gender
Female
Address
1806 E Fir Ave Ste 200, Fergus Falls, MN, 56560-5055
Phone Number
218-998-2992
Fax Number
Provider Enumeration Date
05/10/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1806 E Fir Ave Ste 200
City
Fergus Falls
State
Minnesota
Zip
56537-3921
Phone Number
218-998-2992
Fax Number
person
Provider Business Mailing Address Details
Address
1806 E Fir Ave Ste 200
City
Fergus Falls
State
Minnesota
Zip
56537-3921
Phone Number
218-998-2992
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
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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