Individual
KINGSLEY I EMENIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSN
Contact information
Practice address
1614 19TH AVE E, WEST FARGO, ND 58078-4321
(908) 251-2762
Mailing address
1614 19TH AVE E, WEST FARGO, ND 58078-4321
(908) 251-2762
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R49734
ND
163WC1500X
Community Health Registered Nurse
R49734
ND
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251T00000X
PACE Provider Organization
—
—
372500000X
Chore Provider
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747A0650X
Attendant Care Provider
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
05/29/2025
Last updated
05/29/2025
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