Healthcare Provider Details

I. General information

NPI: 1093661316
Provider Name (Legal Business Name): ROSEMARY MOKO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5148 10TH AVE S
FARGO ND
58103-7242
US

IV. Provider business mailing address

5148 10TH AVE S
FARGO ND
58103-7242
US

V. Phone/Fax

Practice location:
  • Phone: 701-936-2849
  • Fax:
Mailing address:
  • Phone: 701-936-2849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: