Healthcare Provider Details

I. General information

NPI: 1265130710
Provider Name (Legal Business Name): CHARITY GARLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 3RD ST SE
MINOT ND
58701-6319
US

IV. Provider business mailing address

1710 3RD ST SE
MINOT ND
58701-6319
US

V. Phone/Fax

Practice location:
  • Phone: 360-865-7860
  • Fax:
Mailing address:
  • Phone: 360-865-7860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1539
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: