Healthcare Provider Details

I. General information

NPI: 1356265722
Provider Name (Legal Business Name): KENT CARLYLE HAUGLAND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 1ST AVE NE
CROSBY ND
58730-3800
US

IV. Provider business mailing address

11 1ST AVE NE
CROSBY ND
58730-3800
US

V. Phone/Fax

Practice location:
  • Phone: 701-641-0994
  • Fax:
Mailing address:
  • Phone: 701-641-0994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: