Individual
TENILLE BRACKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
922 10TH ST N, FARGO, ND 58102-3504
(701) 850-9607
Mailing address
922 10TH ST N, FARGO, ND 58102-3504
(701) 850-9607
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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