Healthcare Provider Details

I. General information

NPI: 1558297721
Provider Name (Legal Business Name): ARDO GABOSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2036 49TH ST S APT 6
FARGO ND
58103-7794
US

IV. Provider business mailing address

2036 49TH ST S APT 6
FARGO ND
58103-7794
US

V. Phone/Fax

Practice location:
  • Phone: 701-500-3795
  • Fax:
Mailing address:
  • Phone: 701-500-3795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: