Healthcare Provider Details

I. General information

NPI: 1023933934
Provider Name (Legal Business Name): TRANQUIL AND NOURISHED PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 CENTRAL AVE N SUITE 8
KILLDEER ND
58640
US

IV. Provider business mailing address

150 CENTRAL AVE N SUITE 8
KILLDEER ND
58640
US

V. Phone/Fax

Practice location:
  • Phone: 701-690-6495
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY DANBOM
Title or Position: OWNER
Credential: LPC
Phone: 701-690-6495