Healthcare Provider Details

I. General information

NPI: 1477432938
Provider Name (Legal Business Name): JOSEPH S FODAY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6718 28TH ST S
FARGO ND
58104-5518
US

IV. Provider business mailing address

6718 28TH ST S
FARGO ND
58104-5518
US

V. Phone/Fax

Practice location:
  • Phone: 701-333-9692
  • Fax: 701-333-9692
Mailing address:
  • Phone: 701-333-9692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberR54486
License Number StateND

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: