Healthcare Provider Details

I. General information

NPI: 1851222681
Provider Name (Legal Business Name): SIERRA CORNISH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 11TH ST SE APT 112
MINOT ND
58701-3061
US

IV. Provider business mailing address

1635 11TH ST SE APT 112
MINOT ND
58701-3061
US

V. Phone/Fax

Practice location:
  • Phone: 701-389-5682
  • Fax: 701-389-5682
Mailing address:
  • Phone: 701-389-5682
  • Fax: 701-389-5682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: