Healthcare Provider Details

I. General information

NPI: 1063204725
Provider Name (Legal Business Name): NANCY ESCOBEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2517 14TH AVE S APT 204
GRAND FORKS ND
58201-5258
US

IV. Provider business mailing address

2517 14TH AVE S APT 204
GRAND FORKS ND
58201-5258
US

V. Phone/Fax

Practice location:
  • Phone: 218-693-8551
  • Fax:
Mailing address:
  • Phone: 218-693-8551
  • 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: