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Individual

JACQUELINE L BAUERLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPHT, CNA

Contact information

Practice address
2650 32ND AVE NE APT 1, HARVEY, ND 58341-8604
(701) 341-7476
Mailing address
2650 32ND AVE NE, HARVEY, ND 58341-8604
(170) 134-1747

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10014274
PHARMACY TECHNICIAN CERTIFICATION BOARD
ND
05
1451384
ND
01
16373
CERTIFIED NURSING ASSISTANT
ND
Enumeration date
10/09/2020
Last updated
10/09/2020
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