Individual
SHADLINE K SOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3628 CHINOOK DR S UNIT B, FARGO, ND 58104-4643
(401) 390-1117
Mailing address
3628 CHINOOK DR S UNIT B, FARGO, ND 58104-4643
(401) 390-1117
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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