Healthcare Provider Details

I. General information

NPI: 1013870963
Provider Name (Legal Business Name): LADAWN RODINE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N 8TH ST
OAKES ND
58474-1301
US

IV. Provider business mailing address

201 N 8TH ST
OAKES ND
58474-1301
US

V. Phone/Fax

Practice location:
  • Phone: 701-210-2415
  • Fax:
Mailing address:
  • Phone: 701-210-2415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: