Healthcare Provider Details

I. General information

NPI: 1033933932
Provider Name (Legal Business Name): AUBREY N CROSBY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 BAVARIA DR
MINOT ND
58703-1545
US

IV. Provider business mailing address

1615 58TH ST N
NORWICH ND
58768-9526
US

V. Phone/Fax

Practice location:
  • Phone: 701-340-0901
  • Fax:
Mailing address:
  • Phone: 701-340-0901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: