STEPHANIE JALLEN (NPI# 1245541895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245541895 |
| Entity Type | Individual |
| Full Name | STEPHANIE JALLEN |
| Credential | MD |
| Practice Address |
900 E Broadway Ave Bismarck ND 58501-4520 |
| Mailing Address |
Po Box 997 Bismarck ND 58502-0997 |
| Practice Telephone | 7015307300 |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2015-09-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
ME116874 | FL | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
13695 | ND | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 81891 | 05 |
| Street Address |
900 E BROADWAY AVE |
| City | BISMARCK |
| State | ND |
| Zip Code | 58501-4520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720087000 | Kym L Chandler | Neurological Surgery | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2005-07-19 |
| 1538769633 | Brenton Michael Green | Physician Assistant | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-10-28 |
| 1679186852 | Carly Marie Meyer | Pharmacist | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-08-26 |
| 1164030169 | Heather Brooke Flaa | Physician Assistant | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-07-16 |
| 1699393454 | Alexis Schulz | Nurse Practitioner | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-07-08 |
| 1457971012 | Byul You | Pharmacist | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-04-23 |
| 1962021618 | Amanda Mcglasson | Pharmacist | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-04-13 |
| 1336772839 | Deanne Hice | Nurse Anesthetist, Certified Registered | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2020-02-13 |
| 1538707898 | Jenna Etzold | Psychologist | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2019-12-18 |
| 1548811169 | Sarah Skeie | Nurse Practitioner | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500911 | Sonja Lee Bosch | Counselor | 101 E. Broadway Ave Heartview Foundation, Bismarck, ND 58501 | 2020-08-28 |
| 1649740630 | Stephanie Marie Simburger | Social Worker | 3111 East Broadway Ave, Bismarck, ND 58501 | 2018-12-03 |
| 1679042519 | Prairie Rose Family Dentists | Dentist | 1110 College Dr., Suite 110, Bismark, ND 58501 | 2018-11-21 |
| 1386111276 | Arielle Joy Flynn | Genetic Counselor, MS | 414 N Seventh Street, Bismarck, ND 58501 | 2018-10-29 |
| 1164901799 | Karalee Joy Harper | Counselor | 101 E. Broadway Ave, Bismarck, ND 58501 | 2018-08-14 |
| 1518457811 | Myckenzie Saari | Behavior Technician | 1929 N Washington St., Bismarck, ND 58501 | 2018-05-14 |
| 1831687532 | Jacquelyn Mahoney | Behavioral Analyst | 604 North Ave, Bismarck, ND 58501 | 2018-04-27 |
| 1710403811 | Kayla Marie Watson | Behavior Technician | 1500 E. Capitol Ave, Suite 200, Bismarck, ND 58501 | 2017-08-21 |
| 1306368220 | Scott Vandyke | Occupational Therapist | 300 N. 7th St, Bismarck, ND 58501 | 2017-07-12 |
| 1144670019 | Bismarck Psychological Associates, Pllc | Psychologist | 107 W. Main Ave., Suite 225, Bismarck, ND 58501 | 2016-06-21 |
| Find all providers in zip 58501 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124064431 | Laura B Schield | Psychiatry & Neurology | 2787 97th Ave Nw, Bismarck, ND 58503-8452 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376958397 | Kenneth Chidi Asogwa | Psychiatry & Neurology | 860 S Columbia Rd, Grand Forks, ND 58201 | 2014-06-28 |
| 1619297785 | Jacqueline M Bell | Psychiatry & Neurology | 1900-8th Ave. S.e., Minot, ND 58701-4935 | 2010-06-10 |
| 1346479185 | Nivedita Sudhir Nadkarni | Psychiatry & Neurology | 1702 University Drive South, Fargo, ND 58103 | 2009-07-14 |
| 1003952144 | Kondal Madaram | Psychiatry & Neurology | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2007-01-29 |
| 1538218391 | Jane Charlotte Gaffrey | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103-1929 | 2007-01-10 |
| 1326119884 | Deidre L Richards | Psychiatry & Neurology | 1900 8th Ave Se, Minot, ND 58701-4935 | 2006-11-13 |
| 1306867528 | Jeanine L Roembach | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103-1929 | 2006-07-22 |
| 1982622528 | Kenneth J Fischer | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103-1929 | 2006-07-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.