Healthcare Provider Details

I. General information

NPI: 1396559969
Provider Name (Legal Business Name): NEVAEH JOY MCHENRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 12TH ST NW
MINOT ND
58703-0803
US

IV. Provider business mailing address

2029 12TH ST NW
MINOT ND
58703-0803
US

V. Phone/Fax

Practice location:
  • Phone: 701-389-9409
  • Fax:
Mailing address:
  • Phone: 701-389-9409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: