Healthcare Provider Details

I. General information

NPI: 1386244853
Provider Name (Legal Business Name): WENDY B KRIEG C. N. A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 WASHINGTON AVE
HEBRON ND
58638-7019
US

IV. Provider business mailing address

PO BOX 205
HEBRON ND
58638-0205
US

V. Phone/Fax

Practice location:
  • Phone: 701-878-4643
  • Fax:
Mailing address:
  • Phone: 701-878-4643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: