Healthcare Provider Details

I. General information

NPI: 1770496960
Provider Name (Legal Business Name): KELSEY MARIE THRALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9470 COUNTY ROAD 1
HANKINSON ND
58041-9744
US

IV. Provider business mailing address

1311 11TH ST N APT 15
WAHPETON ND
58075-5062
US

V. Phone/Fax

Practice location:
  • Phone: 701-591-6848
  • Fax:
Mailing address:
  • Phone: 701-591-6848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: