Healthcare Provider Details

I. General information

NPI: 1295324143
Provider Name (Legal Business Name): RHONDA LAURICE HUOT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23769 425TH AVE SW
EAST GRAND FORKS MN
56721-9625
US

IV. Provider business mailing address

23769 425TH AVE SW
EAST GRAND FORKS MN
56721-9625
US

V. Phone/Fax

Practice location:
  • Phone: 218-779-5826
  • Fax:
Mailing address:
  • Phone: 218-779-5826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: