Provider Demographics
NPI:1538218391
Name:GAFFREY, JANE CHARLOTTE (DO)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:CHARLOTTE
Last Name:GAFFREY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JANE
Other - Middle Name:CHARLOTTE
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:100 4TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-1929
Mailing Address - Country:US
Mailing Address - Phone:701-234-4141
Mailing Address - Fax:701-234-4137
Practice Address - Street 1:100 4TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1929
Practice Address - Country:US
Practice Address - Phone:701-234-4141
Practice Address - Fax:701-234-4137
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND100952084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry