Individual
KASSIDY DANAE BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 S 43RD ST APT 622, GRAND FORKS, ND 58201-3941
(701) 188-5136
Mailing address
750 S 43RD ST APT 622, GRAND FORKS, ND 58201-3941
(701) 885-1362
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
138503
ND
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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