Healthcare Provider Details

I. General information

NPI: 1275447336
Provider Name (Legal Business Name): SARAH FIDELE SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3342 31ST AVE S APT 18
FARGO ND
58103-6226
US

IV. Provider business mailing address

3342 31ST AVE S APT 18
FARGO ND
58103-6226
US

V. Phone/Fax

Practice location:
  • Phone: 701-306-1060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: