Individual
MISS MANDY L ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8147 35TH ST NE, SHEYENNE, ND 58374-9668
(701) 649-6269
Mailing address
8147 35TH ST NE, SHEYENNE, ND 58374-9668
(701) 649-6269
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58374021213
QSP
ND
Enumeration date
03/08/2021
Last updated
03/08/2021
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