Individual
KRYSTAL LEE TKACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
823 N 12TH ST, BISMARCK, ND 58501-4306
(701) 595-4875
Mailing address
823 N 12TH ST, BISMARCK, ND 58501-4306
(701) 595-4875
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
10/02/2024
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