Provider Demographics
NPI:1619264942
Name:FRAIK, JENNIFER ANN (FNP-C)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN
Last Name:FRAIK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2324 FROHN RD NE
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-7405
Mailing Address - Country:US
Mailing Address - Phone:218-556-3009
Mailing Address - Fax:
Practice Address - Street 1:1500 BIRCHMONT DR NE # 42
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-2699
Practice Address - Country:US
Practice Address - Phone:218-755-2871
Practice Address - Fax:218-755-2750
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1649965363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily