Healthcare Provider Details

I. General information

NPI: 1538078134
Provider Name (Legal Business Name): YASHMIN GHALEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2596 FULTON LOOP S
FARGO ND
58104-2901
US

IV. Provider business mailing address

6663 26TH ST S
FARGO ND
58104-4852
US

V. Phone/Fax

Practice location:
  • Phone: 701-639-3617
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: