| Doctor Name: | JESSICA A BALVITSCH |
| NPI Number: | 1043316524 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | R25536 |
| Business Practice Address: | 414 N 7th St Bismarck, ND - 585014423 |
| Business Phone Number: | 7013236549 |
| Business Fax Number: | 7013235492 |
| Mailing Address: | Po Box 5501, BISMARCK |
| State: | ND |
| Postal Code: | 585065501 |
| Phone Number: | 7013236000 |
| Fax Number: | 7013235709 |
| NPI Enumeration Date: | 09/15/2006 |
| NPI Last Update Date: | 01/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | R25536 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |