Provider Demographics
NPI:1538979075
Name:JENOIR, MARION
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:JENOIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARION
Other - Middle Name:
Other - Last Name:TYSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 478
Mailing Address - Street 2:
Mailing Address - City:TOWNER
Mailing Address - State:ND
Mailing Address - Zip Code:58788-0478
Mailing Address - Country:US
Mailing Address - Phone:562-253-4261
Mailing Address - Fax:
Practice Address - Street 1:3333 8TH ST NE APT M
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-2650
Practice Address - Country:US
Practice Address - Phone:562-253-4261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant