Individual
TRACEY ROSE BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5743 DEB DR W, WEST FARGO, ND 58078-4074
(701) 382-9630
Mailing address
5743 DEB DR W, WEST FARGO, ND 58078-4074
(701) 382-9630
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
ND
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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